Kidney Failure - Acute Renal Failure

Healthy kidneys clean the blood by filtering out extra water and wastes. They also make hormones that keep bones strong and blood healthy.

Renal failure or kidney failure is a situation in which the kidneys fail to function adequately or completely. It is divided in two forms: acute renal failure and chronic renal failure; either form may be due to a large number of other medical problems. In physiological terms, renal failure is described as a decrease in the glomerular filtration rate. When the kidneys malfunction, problems that occur are abnormal fluid levels in the body, deranged acid levels, abnormal levels of potassium, calcium, phosphate, and (in the longer term) anemia. Long-term renal failure problems have significant repercussions on other diseases, such as cardiovascular disease.

Kidney Failure Symptoms:

The most frustrating part of acute renal failure is that a patient does not feel sick at all during the early stages as there are no physical symptoms. However, as the disease worsens, the patient may either need to urinate more often or less. The patients get itchy and loose appetite. The hands and feet swell and become numb and the skin darkens. Symptoms of kidney failure may also include complications such as seizures and coma, which may occur in very severe acute kidney failure patients.

Renal failure is detected by an elevated serum creatinine and urea in the blood accompanied with high blood pressure.

Kidney Failure Tests:

The National Kidney Foundation recommends three simple tests to screen for kidney disease: a blood pressure measurement, a spot check for protein or albumin in the urine (proteinuria), and a calculation of glomerular filtration rate (GFR) based on a serum creatinine measurement. Measuring urea nitrogen in the blood provides additional information.

If the above tests indicate reduced kidney function, the following additional tests are recommended:

• Renal Imaging: This is the process of taking pictures of the kidneys and can be accomplished via ultrasound, computed tomography (CT scan) and magnetic resonance imaging (MRI). These methods are very useful in deducing unusual growths or blockages to the flow of the urine.
• Renal Biopsy: To test a kidney at a cellular level, a sample of the kidney is obtained from a patient through a simple procedure wherein a doctor inserts a needle through the patient’s skin into the back of the kidney. The needle retrieves a strand of the kidney which is about a quarter of an inch long.

Treatment:
As there is no permanent cure for renal failure, the aim of treatment is to control symptoms, reduce complications, and slow the progress of the disease. Blood transfusions or medications such as iron and erythropoietin supplements may be required to control anemia. Fluids may be restricted, often to an amount equal to the volume of urine produced. Restricting the amount of protein in the diet will slow the build up of wastes in the blood and control associated signs of kidney failure such as nausea and vomiting. Salt, potassium, phosphorus, and other electrolytes may be restricted.

Treatment depends partly on the cause and extent of the kidney failure. A patient may be referred to a kidney specialist (nephrologist or urologist). The most important goal is to pinpoint the exact cause of the kidney failure, as that will completely dictate the treatment. Further, the degree to which accumulating wastes and water are affecting the body will impact treatment decisions about medications and the need for dialysis and eventually replacement.

Recovery from acute kidney failure depends on what causes the disease. If the cause does not stem from damage to kidney tissue itself, then the patient will probably make a full recovery. Partial recovery of function may occur in situations in which the injury does not completely resolve.

Acute Renal Failure - Prevention:

An annual physical exam by a health care provider including blood tests and urinalysis to monitor kidney and urinary tract health is a must. One must drink enough fluids to keep kidneys functioning as they should. Further, substances that can poison or damage kidney tissues must be avoided. A health care provider can provide more information about the same. People at risk for chronic kidney disease may need more frequent testing for kidney function and other problems that occur with declining kidney function. Difficulties urinating, blood in the urine or a high blood pressure should prompt a visit to a physician as soon as possible.