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Acute kidney failure

Overview Symptoms Treatment Prevention
Alternative Names:
Renal failure - acute; Kidney failure; Kidney failure - acute; Renal failure; ARF
Treatment:

The goal of treatment is to identify and treat any reversible causes of the kidney failure (e.g., use of kidney-toxic medications, obstructive uropathy, volume depletion). Treatment also focuses on preventing excess accumulation of fluids and wastes, while allowing the kidneys to heal and gradually resume their normal function. Hospitalization is required for treatment and monitoring.

Your fluid intake may be severely restricted to an amount equal to the volume of urine you produce. You may be given specific dietary modifications to reduce build-up of toxins normally handled by the kidneys, including a diet plan high in carbohydrates and low in protein, salt, and potassium.

Antibiotics may be used to treat or prevent infection. Diuretics may be used to remove fluid from the kidney.

A major priority in treatment is to control dangerous hyperkalemia (increased blood potassium levels). A variety of different medications may be used, including IV (intravenous) calcium, glucose/insulin, and oral or rectal administration of potassium exchange resin (Kayexalate).

Dialysis may be used to remove excess waste and fluids. This often makes the person feel better and may make the kidney failure easier to control. Dialysis may not be necessary for all people, but is frequently lifesaving, particularly if serum potassium is dangerously high. Common symptoms that require the use of dialysis include decreased mental status, pericarditis, increased potassium levels, total lack of urine production, fluid overload, and uncontrolled accumulation of nitrogen waste products (serum creatinine > 10 mg/dl and BUN > 120 mg/dl).

Support Groups:
The stress of having an illness can often be helped by joining a support group where members share common experiences and problems. See kidney disease - support group. Your local hospital or dialysis center may also have information regarding local support groups.
Expectations (prognosis):
Although acute renal failure is potentially life-threatening and may require intensive treatment, it usually reverses within several weeks to a few months after the underlying cause has been treated.

A few people will progress to chronic renal failure and/or end-stage renal disease. Death is most common when the cause of the kidney failure is related to surgery or trauma or when it occurs in people with coexisting heart disease, lung disease or recent stroke. Old age, infection, loss of blood from the GI (gastrointestinal) tract, and progression of the kidney failure also increase the risk of death.
Complications:
Calling your health care provider:
Call your health care provider if decreased urine output or other symptoms indicate the possibility of acute renal failure.
Kidney anatomy
Kidney anatomy
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