Acute renal failure, also known as acute kidney injury (AKI), is a sudden and rapid decline in kidney function that occurs over a short period, usually within hours to days.
It can result in the buildup of waste products, electrolyte imbalances, and fluid retention in the body, which can be life-threatening if not promptly treated.
AKI can be reversible with appropriate treatment, but it may also progress to chronic kidney disease or end-stage renal disease in severe cases.
Pictorial representation of Acute renal failure
Causes of Acute Renal Failure
Acute renal failure can be classified into three main categories based on the underlying cause:
1. Prerenal:
This is the most common cause of AKI, resulting from decreased blood flow to the kidneys due to dehydration, blood loss, low blood pressure, heart failure, or sepsis.
2. Intrinsic:
This occurs when there is direct damage to the kidney tissue, such as from acute tubular necrosis, glomerulonephritis, interstitial nephritis, or vascular disorders.
Causes of intrinsic kidney injury include toxins, drugs, infections, and autoimmune diseases.
3. Postrenal:
This is caused by obstruction of urine flow from the kidneys, which can result from kidney stones, blood clots, tumors, or an enlarged prostate.
Pathogenesis of Acute Renal Failure (Acute Kidney Injury)
1. Prerenal Causes:
Sudden drop in blood flow to the kidneys due to severe dehydration, heart failure, or shock.
2. Intrarenal Causes:
Direct damage to the kidneys from toxins, infections, inflammation, or ischemia.
3. Postrenal Causes:
Obstruction of urine flow due to kidney stones, tumors, or enlarged prostate.
Symptoms of Acute Renal Failure
The symptoms of acute renal failure can vary depending on the severity of the condition and the underlying cause.
Common symptoms include:
Decreased urine output
Swelling in the legs, ankles, or feet due to fluid retention
Shortness of breath
Fatigue and weakness
Nausea and vomiting
Confusion or altered mental status
Chest pain or pressure
Seizures or coma in severe cases
Treatment of Acute Renal Failure
The treatment of acute renal failure primarily focuses on addressing the underlying cause and managing the complications associated with kidney dysfunction.
Treatment strategies may include:
Fluid replacement or restriction, depending on the cause of AKI
Medications to control blood pressure, electrolyte imbalances, or anemia
Temporary dialysis to remove waste products and excess fluid from the blood
Treatment of the underlying cause, such as antibiotics for infection or medications for autoimmune diseases