Understanding Acute Kidney Failure: Causes, Symptoms, and Treatment

By Dr. Jatin Kothari in Nanavati Max Institute of Renal Sciences & Transplant , Kidney Dialysis Centre , Kidney Transplant Unit , Kidney Stone Clinic

Nov 24 , 2023 | 7 min read

Preventing acute kidney failure involves addressing the underlying causes and taking proactive measures to protect the kidneys from potential harm. It is a serious condition that requires prompt medical attention to prevent further complications and restore kidney function.

What is Acute Kidney Failure?

Acute kidney failure is a sudden and rapid decline in kidney function. It occurs when the kidneys are unable to filter waste products and excess fluids from the blood effectively.

Symptoms Of Acute Kidney Or Renal Failure

The symptoms of acute kidney/renal failure vary depending on the underlying cause and the severity of the condition. Some common symptoms include:

  • Decreased urine output or no urine output.
  • Swelling in the legs, ankles, or feet due to fluid retention.
  • Fatigue and weakness.
  • Shortness of breath.
  • Nausea and vomiting.
  • Confusion or difficulty concentrating.
  • Chest pain or pressure.
  • Irregular heartbeat.
  • High blood pressure.
  • Seizures or coma (in severe cases).

Acute Kidney Failure Causes

Some common causes of acute kidney failure include:

  • Acute Tubular Necrosis (ATN): This occurs when there is damage to the tubular cells of the kidneys, often due to decreased blood flow (ischemia) or direct injury from medications, toxins, or infections.
  • Severe Dehydration: Significant fluid loss from conditions like vomiting, diarrhea, or excessive sweating can lead to reduced blood volume and impaired kidney function.
  • Acute Glomerulonephritis: Inflammation of the glomeruli (tiny blood vessels in the kidneys) caused by infections, immune system disorders, or certain medications can result in acute kidney failure.
  • Urinary Tract Obstruction: Blockages in the urinary tract, such as kidney stones, tumors, or enlarged prostate gland, can prevent urine from draining properly, causing a build-up of pressure and potential kidney damage.
  • Medications and Toxins: Certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), antibiotics, and contrast agents used in imaging studies, as well as exposure to toxic substances like heavy metals or solvents, can cause acute kidney failure.
  • Hemodynamic Instability: Conditions that disrupt blood flow to the kidneys, such as severe blood loss, low blood pressure (hypotension), heart failure, or severe infections (sepsis), can lead to acute kidney failure.
  • Autoimmune Diseases: Autoimmune conditions like lupus or vasculitis can cause inflammation and damage to the kidneys, leading to acute renal failure.
  • Infections: Serious infections, particularly those affecting the kidneys directly (pyelonephritis) or causing systemic infection (sepsis), can result in acute kidney failure.

Acute Kidney Failure Risk Factors

Advanced age, pre-existing kidney disease, chronic health conditions (diabetes, high blood pressure, etc.), certain medications (NSAIDs, antibiotics, contrast agents), and conditions and conditions that compromise blood flow to the kidneys, such as severe infections and low blood pressure, are risk factors for acute kidney failure.

Acute Kidney Failure Complications

Complications of acute kidney failure can include electrolyte imbalances, fluid overload, pulmonary edema (fluid in the lungs), metabolic acidosis, high blood potassium levels (hyperkalemia), uremia (buildup of waste products in the blood), and in severe cases, organ failure or death if not treated promptly.

Acute Kidney Failure Prevention

Preventing acute kidney failure involves maintaining overall kidney health. This includes staying hydrated, managing chronic conditions like diabetes and high blood pressure, avoiding nephrotoxic medications or substances, maintaining a healthy diet, and promptly treating infections or conditions that can affect kidney function. Regular check-ups and screenings are also essential.

Kidney Failure Treatment

The common treatments for kidney failure include:

  • Dialysis removes waste products and excess fluids from the blood when the kidneys are unable to perform this function adequately.
  • Kidney transplantation restores kidney function, eliminating the need for dialysis.
  • Medications may be prescribed to manage underlying conditions contributing to kidney failure, control blood pressure, reduce swelling, and prevent complications.
  • Dietary changes like controlling the intake of sodium, potassium, phosphorus, and protein to reduce the workload on the kidneys.
  • Treatment of underlying causes such as diabetes or high blood pressure is crucial to slow down the progression of kidney damage.

It's important to work with healthcare professionals to determine the most suitable treatment plan for your specific situation.

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What Medications are Used To Treat Kidney Failure?

Your medical team will choose medications depending on the cause of kidney failure. The common medicines used for treating kidney failure are:

  • Diuretics: These medications help increase urine output and reduce fluid retention, thereby relieving swelling (edema).
  • Phosphate Binders: Phosphate binders are used to control high levels of phosphorus in the blood.
  • Erythropoiesis-Stimulating Agents (ESAs): ESAs stimulate the production of red blood cells and are used to treat anemia.
  • Antihypertensive Medications: High blood pressure is a common complication of kidney failure.
  • Immunomodulators: In certain cases of kidney failure, such as autoimmune-related kidney diseases, immunomodulatory medications like corticosteroids or immunosuppressants may be prescribed to suppress the immune system and reduce inflammation.
  • Medications for Mineral and Bone Disorders: In advanced kidney failure, abnormalities in mineral and bone metabolism can occur. Medications like calcimimetics and vitamin D analogs are used to regulate calcium, phosphorus, and parathyroid hormone levels.

What do The Kidneys Do?

The kidneys filter waste products, excess water, and toxins from the blood, producing urine for their elimination. They help regulate electrolyte balance, blood pressure, and acid-base balance and contribute to the production of red blood cells. Overall, the kidneys are responsible for maintaining fluid and electrolyte homeostasis, detoxification, and various metabolic functions in the body.

Who is Most Affected by Kidney Failure?

Kidney failure can affect individuals of all ages, genders, and backgrounds. Certain populations may be more susceptible to kidney failure, including older adults, individuals with chronic conditions like diabetes or high blood pressure, those with a history of kidney disease or kidney stones, and individuals who are exposed to certain medications or toxins.

How Common Is Kidney Failure?

The exact prevalence of kidney failure varies among different populations. Approximately 10% of the global population is affected by chronic kidney disease, a leading cause of kidney failure. The incidence and prevalence of kidney failure increase due to the aging population, rising rates of diabetes and hypertension, and other risk factors.

What Happens When Kidney Failure Starts?

Kidney failure can lead to a buildup of waste products and fluid in the body, causing symptoms like fatigue, swelling, and changes in urine output. If left untreated, kidney failure can be life-threatening.

Is Kidney Failure Contagious?

No, kidney failure is not contagious. Kidney failure typically occurs due to various underlying factors such as chronic diseases, infections, certain medications, or other medical conditions. It is not caused by a contagious agent like a virus or bacteria.

What Can I Expect If I Have Kidney Failure?

If you have kidney failure, you can expect a significant impact on your health and daily life. Symptoms may include fatigue, swelling (edema), decreased urine output, nausea, and difficulty concentrating.

When Should I See a Healthcare Provider?

You should see a healthcare provider if you experience any symptoms related to kidney function or if you have risk factors for kidney disease. These symptoms include persistent fatigue, swelling in the legs or ankles, changes in urine output, persistent nausea or vomiting, unexplained weight loss, or changes in appetite. If you have conditions such as diabetes, high blood pressure, or a family history of kidney disease, it is important to have regular check-ups with a healthcare provider to monitor your kidney health.

Can A Person Recover From Kidney Failure?

In some cases, a person with kidney failure can recover partially or even fully, but it depends on the underlying cause and the individual's overall health. Acute kidney failure may be reversible with timely and appropriate treatment.

However, chronic kidney failure, which occurs over a longer period, is generally not reversible. The goal of treatment is to manage the condition, slow down the progression, and maintain the best possible kidney function.

Frequently Asked Questions (FAQ’s)

How Long Can You Live with Acute Kidney Failure?

The prognosis and life expectancy for acute kidney failure vary depending on various factors, including the underlying cause, the overall health of the individual, and timely intervention. In some cases, acute kidney failure can be reversible. However, if the underlying cause is severe or if complications arise, the prognosis may be more concerning.

Can Acute Kidney Failure be Fixed?

Acute kidney failure can sometimes be reversed with timely treatment addressing the underlying cause, such as dehydration or medication adjustment. However, the outcome depends on the severity of the damage and complications. Prompt medical intervention improves the chances of recovery, but not all cases can be fully reversed.

What are The Warning Signs Of Acute Kidney Failure?

Warning signs may include decreased urine output or no urine output, swelling in the legs or ankles, fatigue, nausea and vomiting, shortness of breath, confusion or difficulty concentrating, chest pain, irregular heartbeat, and high blood pressure.

What Are The 3 Types Of Acute Renal Failure?

The three types of acute renal failure are prerenal, intrinsic, and postrenal. Prerenal failure occurs due to decreased blood flow to the kidneys. Intrinsic failure involves direct damage to the kidney tissue. Postrenal failure results from urinary tract obstruction, preventing urine flow from the kidneys.

Is Acute Kidney Failure Painful?

The underlying conditions or complications that can lead to acute kidney failure may cause pain. For example, kidney stones, urinary tract infections, or inflammation of the kidney (nephritis) can cause pain in the lower back, abdomen, or side. If there are other symptoms or complications such as fluid overload or electrolyte imbalances, they can cause discomfort or other sensations.

What Causes Acute Kidney Damage?

Acute kidney damage can be caused by various factors, including severe dehydration, reduced blood flow to the kidneys, medication toxicity (such as certain antibiotics or NSAIDs), urinary tract obstructions, infections (such as pyelonephritis), autoimmune diseases, and direct kidney injury due to trauma or exposure to harmful toxins.