Human kidneys work round the clock where they filter 180-200 liters of blood every day. In this process, the kidney removes excess salts, fluids, and waste materials such as drug metabolites from the blood.
What if the kidneys lose this filtering ability?
All the waste gets accumulated in the body along with extra fluids. Electrolytes, wastes, and fluids rise to dangerous levels that could lead to a myriad of issues in the body. At times, this situation can be life-threatening too.
This inability of kidneys to perform their core functions is termed “acute kidney failure”, “acute kidney injury” or “acute renal failure”.
Over 13 million people around the world have acute kidney failure. It is common in patients who are already suffering from chronic diseases such as diabetes and hypertension. Evidence shows that people with diabetes are at around 40% higher risk of getting acute kidney failure complications as compared to the ones without diabetes. Additionally, critically ill patients, especially the ones in intensive care units are at the highest risk of developing acute kidney/renal failure.
Although acute kidney failure can be life-threatening and requires intensive treatment, it may be reversed with proper medication and care.
Hence, this article circles around every piece of information that you need to know about acute kidney failure, right from its causes to the treatment options.
Give it a read!
What are some common causes of acute kidney failure?
There are many causes behind the development of acute kidney failure. Some of the common ones are listed below:
1. Reduced blood flow to the kidneys:
A decrease in the blood flow to the kidneys can damage the blood vessels in the kidneys and lead to a reduced filtration rate. Some common causes of reduced blood flow to the kidneys are:
- Chronic diseases such as cardiovascular disorders, liver cirrhosis, and so on
- Low blood pressure
2. Clotting within the kidney’s blood vessels
Blood clots in the kidney’s blood vessels can hamper the blood flow in the kidneys and lead to acute kidney failure. These blood clots can be caused by the following conditions:
- Trauma in the abdomen, side, or back region
- Certain infections in the kidneys
- Inflammation of blood vessels in the body (vasculitis)
- Toxin overload in the kidneys (especially from heavy metals)
- Malignant hypertension
- Reactions to blood transfusion
3. Infections and injuries in the kidneys
Infections and injuries to the kidneys are among the common causes od kidney functions’ damage and acute kidney failure.
A kidney infection may start in the urethra, the tube that drains urine from the body, or in the bladder. The infection has the potential to spread to one or both kidneys. A kidney infection needs immediate medical attention. If left untreated, these infections can damage the blood vessels in the kidneys and lead to acute kidney injury. Some common examples of kidney infections are listed below:
- Pyelonephritis, a bacterial infection in the kidney that can cause inflammation and clots in the blood vessels.
- Hemolytic uremic syndrome, a complex condition caused as a result of gastrointestinal tract infections that damages the RBCs and blood platelets. These damaged cells could clog up to form a clot in the blood vessels.
- Septicemia, a state of severe infection either due to surgery or critical illness, could lead to blood clots and damage the kidney functions.
4, Pregnancy-related complications
Ectopic pregnancy, abortion, obstetric hemorrhage, placental abruption, trauma and uterine rupture during child birth can increase the risk of acute kidney failure in women of reproductive age.
5. Autoimmune kidney diseases
Autoimmune diseases such as acute nephritic syndrome and interstitial nephritis can result into significant damage to the kidneys causing acute kidney failure or acute kidney injury.
Apart from these, there are many factors that could increase the risk of kidney diseases. Here is a list of top 10 factors among them that need to be treated or managed to prevent the occurrence of acute kidney failure:
- Uncontrolled diabetes
- Heart failure
- Liver diseases
- Kidney diseases
- Critical illness and long-term hospitalization
- Abdominal surgery
- Bone marrow transplant
- Heart surgery
Symptoms of acute kidney failure
Here’s the list of some common symptoms of acute kidney failure:
- Loss of appetite
- Water retention or swelling
- Easy bruising
- Hand tremor
- Bad breath
- Blood in the feces or stool
- Extreme fatigue and difficulty while doing movements
- Nausea and vomiting
- Metallic taste in the mouth
- Reduced sensation in the hands and feet
- High blood pressure
- Mood disorders
- Mental health issues
- Pain in the region between ribs and abdomen
Complications of acute kidney failure
If left untreated acute kidney failure can lead to following complications:
- Chronic kidney failure
- Heart damage
- Progression to chronic kidney disease
- Damage to the nervous system
- High blood pressure
When these conditions progress to the advanced stages, they can also manifest as fatal clinical conditions for patients with acute kidney failure.
How does the doctor diagnose acute kidney failure?
Apart from a general check-up using a stethoscope, the doctor might order for following tests to diagnose acute kidney failure:
- Estimated Glomerular Filtration Rate (eGFR)
- Serum potassium
- Serum sodium
- Creatinine clearance
- Serum creatinine
- Blood urea nitrogen (BUN)
Apart from these tests, the doctor might also ask for abdominal X-ray scans, CT scans, and MRI to check if there is any obstruction in the urinary tract.
Treatment of acute kidney failure
The main goals for the treatment of acute kidney failure are to prevent fluids and wastes from building up in the body and to aid the recovery of the kidneys from injury. It is advisable to visit a nephrologist (kidney disease specialist) to get the correct direction on the treatment of acute kidney failure.
Here are some common treatments suggested for acute kidney injury:
1. Dietary and lifestyle remedies:
Dietary and lifestyle modifications are among the cheapest and most feasible treatment options for acute kidney failure. Here are the common dietary tips recommended by all the renal specialized dieticians for patients with acute kidney injury:
- Choose low potassium foods such as apples, cauliflower, grapes, peppers, strawberries and so on. It is advisable to avoid consuming high-potassium foods such as tomatoes, potatoes, spinach, banana, and so on.
- Avoid consuming high-phosphorous foods such as cola, and other dark-colored beverages and try to consume plant-based foods over animal-based foods as they are relatively low in phosphorous.
- Say no to high sodium foods such as foods with added salt, refined foods, chips, packaged snacks, readymade pickles, and so on.
Consult a renal dietician to get personalized dietary recommendations that could help with the healing of acute kidney injury.
2. Medications to treat the underlying cause of acute kidney injury:
As seen above, there are multiple causes of acute kidney failure. Hence, the doctor might prescribe the medicines to cure these causes in order to help with the healing of acute kidney injury. For instance, in the case of diabetic nephritis, the doctor might prescribe you some medications to address diabetes and thus ensure kidney recovery.
3. Treatment to manage the complications of acute kidney injury:
Additionally, doctor also seeks to prevent kidney-related complications in order to give the kidneys enough time to recover. These complication-prevention treatments include:
A. Treatments to balance the fluid levels in your blood:
Intravenous (IV) fluids are used if your acute kidney failure is caused by a shortage of fluids in your blood. On the other hand, in some cases, fluid retention also emerges as a complication resulting from severe renal failure. This might lead to prominent swelling in the legs and arms. In this situation, a doctor usually prescribes diuretics that help to remove excess fluid from the body.
B. Medications to increase the serum calcium levels:
Doctors may recommend calcium supplements to patients with acute kidney failure as low serum calcium levels are associated with worsening of kidney damage.
C. Blood potassium-controlling medications:
High blood potassium levels can lead to irregular heartbeats and muscle fatigue. Thus, if the kidney loses the ability to filter potassium from the blood adequately, doctor may prescribe calcium, glucose, or sodium polystyrene sulfonate to prevent an excess in the blood potassium levels.
Dialysis is one of the treatments used for patients with acute kidney failure at times. However, not all of them require dialysis. It is required when the mental state of the patient changes or he/she completely stops urinating. It may also be required for patients who develop inflammation in the heart.
The main aim of dialysis is to aid in removal of the nitrogen waste products from the body. This is achieved by transferring blood from the body to a machine that filters trash and returns the clean blood to the body.
Dialysis can also help to manage normal potassium levels in the bloodstream, thus, preventing the complications of acute kidney failure.
Prevention is always better than cure!
It is always better to prevent acute kidney failure and make constant efforts in this direction. Some of the simple ways to prevent acute kidney failure are:
- Eat a healthy and balanced diet
- Exercise regularly and stay physically active
- Manage your blood sugar levels (if you are diabetic or pre-diabetic)
- Maintain a healthy body weight
- Try to manage blood pressure
- Reduce the amount of table salt in the diet (Limit to 1-2 teaspoons of table salt per day)
- Manage stress levels
- Limit alcohol intake
- Avoid smoking
- Limit over-the-counter pain medications
Thus, there are multiple causes of acute kidney failure. This could include chronic diseases, reduced blood flow, blood clots, pregnancy-related complications and so on.
The patient with acute kidney failure might experience a wide spectrum of symptoms ranging from fatigue to high blood pressure, swelling and fluid retention, and many more. If left untreated, acute kidney failure can lead to fatal complications such as heart failure.
Thus, it is essential to treat this condition as soon as possible. Above all, prevention is always better than cure. Hence, it is highly recommended to eat a healthy diet, exercise regularly and follow healthy habits such as limiting alcohol and smoking in order to prevent acute kidney failure and its complications.