Acute renal failure
Alternative names:
A.R.F.; acute kidney failure; kidney failure; kidney failure - acute; renal failure; renal failure - acute
Treatment:
The goal of treatment of acute renal failure includes identifying and treating any reversible causes of the kidney failure (e.g., use of nephrotoxic medications, obstructive uropathy, volume depletion...). Additionally, treatment focuses on preventing the excess accumulation of fluids and wastes, while allowing the kidneys to heal. The kidneys may gradually resume function. Hospitalization is required for treatment and monitoring.
Fluid intake may be severely restricted to an amount equal to the volume of urine produced. Salt intake is usually also curtailed. Dietary intake of substances that are normally excreted by the kidney may be restricted to minimize their build up in the body. Specific dietary modifications will include following a diet plan that is high in carbohydrates, low in protein, sodium, and potassium intake.
Antibiotics may be used to treat or prevent infection. Diuretics may be tried in an attempt to increase the excretion of fluid from the kidney. Medications may be given to control hyperkalemia (increased blood potassium levels).
A major priority in treatment is to control dangerous hyperkalemia (increased blood potassium levels). A variety of different medications may be utilized to reduce blood potassium 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. 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) are common indications for dialysis.
SUPPORT GROUP:
The stress of illness can often be helped by joining support groups where members share common experiences and problems. See kidney disease - support group.
Expectations (prognosis):
Although acute renal failure is potentially life threatening and may require intensive treatment for a time, 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 acute renal failure may be present.
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