Acute Renal Failure Or Kidney Failure Acute | What Is It Exactly?

Acute renal failure or Acute kidney failure (AKF) occurs when kidneys suddenly become unable to filter waste products from blood. When kidneys lose their filtering ability, it results in accumulation of nitrogenous wastes and fluid and electrolyte imbalance. Acute renal failure is also called acute kidney injury (AKI). It develops rapidly over a few hours or a few days.

Epidemiology In ARF OR Acute kidney failure (AKF)

Acute kidney injury is common among hospitalized patients particularly in critically
ill people who need intensive care. It affects some 3-7% of patients admitted to the
hospital and approximately 25-30% of patients in the intensive care unit.

Acute renal failure OR Acute kidney failure (AKF) Causes

Acute renal failure can occur when:

(i) Impaired Blood Flow to the Kidneys: Diseases and conditions that may slow blood flow to the kidneys and lead to kidney failure include:

•  Blood or fluid loss.
• Blood pressure medications.
• Heart attack.
• Heart disease.
• Infection.
• Liver failure.
• Use of Aspirin, Ibuprofen and Naproxen.
• Severe allergic reaction (anaphylaxis).
• Severe burns.
• Severe dehydration.

(ii) Damage to the Kidneys: Certain diseases, conditions and agents may damage the kidneys and lead to acute renal failure includes:

• Blood clots in the veins and arteries in and around the kidneys.
• Cholesterol deposits that block blood flow in the kidneys.
• Glomerulonephritis, inflammation of the tiny filters in the kidneys (glomeruli).
• Hemolytic uremic syndrome, a condition that results from premature destruction of red blood cells.
• Lupus, an immune system disorder causing glomerulonephritis.
• Medications, such as certain chemotherapy drugs, antibiotics, dyes used during imaging tests and zoledronic acid, used to treat osteoporosis and high blood calcium levels (hypercalcemia).
• Multiple myeloma, a cancer of the plasma cells.
• Scleroderma, a group of rare diseases affecting the skin and connective tissues.
• Thrombotic thrombocytopenic purpura (TTP), a rare blood disorder.
• Toxins, such as alcohol, heavy metals and cocaine.
• Vasculitis, an inflammation of blood vessels.

(iii) Urine Blockage in the Kidneys: Diseases and conditions that block the passage of urine out of the body (urinary obstructions) and can lead to acute renal failure include:

• Bladder cancer,
•  Blood clots in the urinary tract,
• Cervical cancer,
• Colon cancer,
•  Enlarged prostate,
•  Kidney stones,
• Nerve damage involving the nerves that control the bladder,
• Prostate cancer.

Etiologic Mechanisms in  ARF OR Acute kidney failure (AKF)

Etiologic mechanisms in ARF

Prerenal Failure

Mechanism: Reduced renal blood flow Severe dehydration shock (all forms)

• Cardiac failure
• Renal artery stenosis
• Renal artery embolism or thrombosis
• Sickle cell crisis

Intrarenal Failure

Mechanism: Renal parenchymal disease

• Ischemic necrosis Nephrotoxicity
• Autoimmune or isoimmune disorders
• Hypertensive nephropathy
• Diabetic nephropathy
• Renal trauma
• Acute glomerulonephritis
• Vasculitis
• Acute interstitial nephritis,
• Rhabdomyolysis

Postrenal Failure

Mechanism: Prevention of Filtration Due to High tubular pressure (obstructed outflow)

• Urolithiasis
• Renal-urinary neoplasms
• Congenital obstructive uropathies
• Detrusor areflexia
• Surgical trauma to ureters
• Obstructive lymphadenopathy

Risk Factors In Acute renal failure OR Acute kidney failure (AKF)

Acute renal failure almost always occurs in connection with another medical condition or events. Conditions that can increase risk of acute renal failure include:

•  Being hospitalized, especially for a serious condition that requires intensive care,
• Advanced age,
•  Blockages in the blood vessels in arms or legs (peripheral artery disease),
•  Diabetes,
•  High blood pressure,
•  Heart failure,
• Kidney diseases,
•  Liver diseases.

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