Acute Renal Failure

Acute Renal Failure (ARF) is the sudden loss of kidney function. It occurs when the kidneys stop working over a period of hours, days, or in some cases, weeks. ARF develops from 5% to 7% of all patients in the hospital.  


Causes–

Pre-renal

  • Hypovolemia
  • Dehydration
      1. Vomiting
      2. Diarrhea
      3. Sweating
      4. Fever
      5. Poor intake of fluids
  • Medication(diuretics )
  • Abnormal blood flow to and from the kidney due to obstruction of the renal artery or vein.

Renal

  • Sepsis
  • Medications
      1. NSAID’s(ibuprofen,naproxen)
      2. Antibiotics (aminoglycosides)
      3. Iodine-containing medications
      4. Lithium
  • Rhabdomyolysis
  • Multiple myeloma
  • Acute glomerulonephritis
  • Systemic lupus erythematosus
  • Wegener’s granulomatosis
  • Goodpasture syndrome

Post renal

  • Obstruction of the bladder or the ureters
  • Prostrate –hypertrophy/cancer
  • Tumors in the abdomen
  • Kidney stones(if single kidney is present)   

Symptoms And Signs–

  • Anuria
  • Bloody stools
  • Breath odor
  • Bruising easily
  • Changes in mental status or mood
  • Decreased appetite
  • Decreased sensation (hands or feet)
  • Fatigue
  • Flank pain (between the ribs and hips)
  • Frequent urination
  • Hand tremor
  • Hypertension
  • Metallic taste in mouth
  • Nausea or vomiting, may last for days
  • Nosebleeds
  • Oliguria
  • Persistent hiccups
  • Prolonged bleeding
  • Seizures
  • Slow, sluggish movements
  • Swelling(generalized)
  • Swelling of the ankle, feet, and leg swelling

Investigations—

  • Blood tests—
    1. creatinine
    2. BUN (Blood urea nitrogen)
    3. CBC
  • Urine C/E
  • USG

Treatment—-                     

  • Diet (high in carbohydrates and low in protein, salt and potassium)
  • Ayurvedic Medicines
  • Dialysis

Complications—-

  • Recurrent Infection
  • Uremic syndrome (uremia)
  • Increased potassium in the blood

 

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