AcuteRenal Failure

AcuteRenal Failure

Acute kidney failure is the rapid (less than 2 days) loss of the kidneys' ability to remove waste and help balance fluids and electrolytes in the body.

Causes

•          Acute tubular necrosis (ATN)

•          Autoimmune kidney disease

•          Blood clot from cholesterol (cholesterol emboli)

•          Decreased blood flow due to very low blood pressure, which can result from burns, dehydration, hemorrhage, injury, septic shock, serious illness, or surgery

•          Disorders that cause clotting within the kidney blood vessels

•          Infections that directly injure the kidney, such as acute pyelonephritis or septicemia

•          Pregnancy complications, including placenta abruption or placenta previa

•          Urinary tract blockage

Signs and Symptoms.

•          Bloody stools

•          Breath odour and metallic taste in the mouth

•          Bruising easily

•          Changes in mental status or mood

•          Decreased appetite

•          Shortness of breath

•          Slow, sluggish movements

•          Swelling due to the body keeping in fluid (may be seen in the legs, ankles, and feet)

•          Urination changes, such as little or no urine, excessive urination at night, or urination that stops completely

•          Decreased sensation, especially in the hands or feet

•          Fatigue

•          Flank pain (between the ribs and hips)

•          Hand tremor

•          High blood pressure 

•          Nausea or vomiting, may last for days

•          Nosebleeds

•          Persistent hiccups

•          Prolonged bleeding

•          Seizures

Investigations

• BUN
• Creatinine clearance
• Serum creatinine
• Serum potassium
• Urinalysis
• X-ray, CT scan, or MRI of the abdomen

     Treatments

• Correction of fluid overload with furosemide.

• Correction of severe acidosis with bicarbonate administration, which can be important as a bridge to dialysis.

• Correction of hyperkalemia.

• Correction of hematologic abnormalities (eg, anemia, uremic platelet dysfunction) with measures such as transfusions and administration of desmopressin or estrogens.

• Decreasing the intake of potassium in diet or tube feeds.

• Exchanging potassium across the gut lumen using potassium-binding resins.

• Promoting intracellular shifts in potassium with insulin, dextrose solutions, and beta agonists.

• Instituting dialysis.

   REFERENCES

• B. T Workeneh, V. Batuman. (2014, 09 15). Acute Kidney Injury Treatment & Management. Retrieved 05 08, 2015, from medscape: http://emedicine.medscape.com/article/243492-treatment

• C.Silberberg. (2014, 07 24). Acute kidney failure. Retrieved 05 08, 2015, from MedlinePlus: http://www.nlm.nih.gov/medlineplus/ency/article/000501.htm