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Acute kidney failure

Kidney failure; Renal failure; Renal failure - acute; ARF; Kidney injury - acute

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

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Kidney anatomy

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Causes

There are many possible causes of kidney damage. They include:

Symptoms

Symptoms of acute kidney failure may include any of the following:

Exams and Tests

The health care provider will examine you.

Tests to check how well your kidneys are working include:

Other blood tests may be done to find the underlying cause of kidney failure.

A kidney or abdominal ultrasound is the preferred test for diagnosing a blockage in the urinary tract. X-ray, CT scan, or MRI of the abdomen can also tell if there is a blockage.

Treatment

Once the cause is found, the goal of treatment is to help your kidneys work again and prevent fluid and waste from building up in your body while they heal. Usually, you will have to stay overnight in the hospital for treatment.

The amount of liquid you drink will be limited to the amount of urine you can produce. You will be told what you may and may not eat to reduce the buildup of toxins that the kidneys would normally remove. Your diet may need to be high in carbohydrates and low in protein, salt, and potassium.

You may need antibiotics to treat or prevent infection. Water pills (diuretics) may be used to help remove fluid from your body.

Medicines will be given through a vein to help control your blood potassium level.

You may need dialysis. This is a treatment that does what healthy kidneys normally do -- rid the body of harmful wastes, extra salt, and water. Dialysis can save your life if your potassium levels are dangerously high. Dialysis will also be used if:

Dialysis will most often be short term. In some cases, the kidney damage is so great that dialysis is needed permanently.

When to Contact a Medical Professional

Call your provider if your urine output slows or stops or you have other symptoms of acute kidney failure.

Prevention

To prevent acute kidney failure:

Related Information

Electrolytes
Septic shock
Burns
Dehydration
Acute tubular necrosis
Renal
Acute arterial occlusion - kidney
Rhabdomyolysis
Alcohol use and safe drinking
Crush injury
Seizures
Septicemia
Tumor
Kidney stones
Nephrocalcinosis
Acute nephritic syndrome
Immune thrombocytopenic purpura (ITP)
Hemolytic transfusion reaction
Malignant hypertension
Placenta abruption - definition
Autoimmune disorders
Scleroderma
Hemolytic-uremic syndrome
High blood pressure - adults

References

Molitoris BA. Acute kidney injury. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 120.

Oh MS, Briefel G. Evaluation of renal function, water, electrolytes, and acid-base balance. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 23rd ed. St Louis, MO: Elsevier; 2017:chap 14.

Sharfuddin AA, Weisbord SD, Palevsky PM, Molitoris BA. Acute kidney injury. In: Skorecki K, Chertow GM, Marsden PA, Taal MW, Yu ASL, eds. Brenner and Rector's The Kidney. 10th ed. Philadelphia, PA: Elsevier; 2016:chap 31.

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Review Date: 4/13/2018  

Reviewed By: Walead Latif, MD, Nephrologist and Clinical Associate Professor, Rutgers Medical School, Newark, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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