Overview of acute renal failure

Overview of acute renal failure

The kidneys are two organs of pea has a small size (approximately 1 fist) located 2 the spine just below the lowest ribs. The kidneys function to filter the products and toxins in the blood and make sure the fluid and electrolyte balance of the body.

Working mechanism of the kidney and renal disease

- Kidney emissions combine with water to form urine.
- We also have the function to remove the excess water of the body while re-absorbed back the quality is still good for the body and for the waste can pass through freely to the bladder under form of urine.
- We can help people eat a variety of foods, drugs, vitamins, functional foods and drink plenty of water without fear of toxins emitted from them can accumulate in the body to a concentration be harmful.
- The kidneys regulate the amount of blood and water in the body.
Blood to pass through the kidneys to be filtered.
- First, the blood passes through the glomerulus, a vascular complex include small hug. The presence in the blood is filtered selectively through the membrane of the small blood vessels and is discharged along with water in the form of urine or reabsorbed back into a tubular structure to be filtered to .
- The dialysis tube continues until all the qualities needed to be re-absorbed back back to the blood and all the waste products are excreted.
- When urine leaves the kidney, it continues to move in a long and narrow tube called the ureter to the bladder and urethra during urination.
The kidneys also help regulate blood pressure and secretes the hormones involved in the production of red blood cells.
Renal failure means the kidneys lose part or totally capable of filtering water and the waste products from the blood. Toxic substances normally removed from the body but when renal accumulation of potentially dangerous for the body.
Acute renal failure occurs in approximately 5% of people admitted to hospital for any reason whatsoever. For those who have room in intensive care, the rate is even higher.
Chronic renal failure as the disease destroys the body slowly. Destruction occurred for many years, often without symptoms until end-stage renal failure. This process occurs slowly enough to not have symptoms until kidney function is less than 1/10 compared to normal.

Cause of renal failure can be divided into three groups:

- Before the kidney: are abnormalities affecting the blood stream before it reaches the kidneys.
- After care: is the anomaly affects the movement of urine out of the kidney.
- In: abnormalities of renal dialysis prevent the production or urine.
Renal failure before renal
Renal kidney failure is the most common type of acute renal failure (60 - 70% of cases). The kidneys do not receive enough blood to filter. Renal kidney failure may be due to the following:
- Dehydration: due to vomiting, diarrhea, diuretics or anemia.
- No blood to the kidneys is due to many reasons:
+ Blood pressure dropped sharply due to a large blood loss surgery, trauma or burns, or sepsis.
+ The blood vessels to the kidney blocked or narrow
+ Heart failure or myocardial infarction causes decreased blood flow
+ Liver failure leads to changes in hormones affect renal blood flow and pressure.
Care not to damage it in the early stages of the process before renal failure. If treated with appropriate methods, these abnormalities may return to normal. Reduced blood flow to the kidney lasts, though for whatever reason, can also cause permanent damage to the renal parenchyma.
Renal failure after kidney

Renal failure after kidney sometimes associated with obstructive renal failure due to something blocking the renal excretion of urine was produced. This is a rare cause of acute renal failure (about 5 - 10% of cases). This situation can be restored to normal except when congestion existed long enough to cause damage to the renal parenchyma.

One ureter obstruction may be due to the following reasons:

- Urinary stones: usually only on one side.

- Cancer of the agencies attached to the urethra or structures near the urethra can cause blockage of urine flow.

- Do drugs.

Bladder obstruction may be due to the following reasons:
- Bladder stones

- Prostate hypertrophy (the most common cause in men)

- Blood clots

- Bladder Cancer

- Neurogenic bladder disease reduces the ability of the bladder

The treatment is free of obstruction. Once freed, the kidney will usually recover within 1 to 2 weeks if there is no infection or other problems.
Kidney damage
Primary renal lesion is the most complex causes of renal failure (approximately 25 to 40% of cases). What in the kidneys causes of kidney failure include the reasons affecting the filtering function of the kidneys, the blood supply system within the kidney and renal parenchymal function to regulate the salt and water.
Some in the kidneys can cause kidney failure include:
- Vascular disease

- Blood clots in the blood vessels of the kidney

Parenchymal lesions and renal cell

- Inflammation of the glomerulus

- Acute interstitial nephritis

- Acute tubular necrosis

Inflammation of the glomeruli: glomerular, the first filtration system of the kidneys can be damaged by many different diseases, including infections result is cause renal dysfunction.
- The most common is a sore throat caused by streptococcal. Streptococcal bacteria can damage the glomeruli.

- Unusual symptoms of glomerulonephritis may include dark colored urine (like cola or tea) and back pain.

- Other symptoms include producing less urine than normal, blood in the urine, high blood pressure and edema (water retention by the body)

- Treatment usually includes medication and if markedly impaired renal function may require dialysis to remove the waste products capable of threatening that can not be excreted.

Acute interstitial nephritis: a sudden decline of kidney function due to renal interstitial inflammation plays a major role is to keep the balance of salt and more water is to filter waste products.
- The most common cause is oral medications such as antibiotics, anti-inflammatory (aspirin, ibuprofen) and diuretics.

- Other causes include infections and diseases related to the immune system, such as lupus, leukemia, lymphoma, and sarcoidosis.

- Often can be restored if the kidneys are not seriously injured

- Treatment includes stopping the drug influence, infections and dialysis treatment in the case of the remaining kidney function is very low.

Acute tubular necrosis: the renal tubular injury and can not function normally. Tubular necrosis is usually the end result of other causes of acute renal failure. Tubules are structures took most sophisticated filtering function of the kidneys. When necrosis, renal tubular cells that make up useless and "dead"
This condition accounts for about 90% of primary cases of acute renal failure.

- Causes include shock (reduced blood flow to the kidneys), drugs (especially antibiotics) and those used in chemotherapy, toxins and dyes used in some types of x-rays.

- Some people make urine less than normal lot. Other symptoms of acute tubular necrosis include: fatigue, edema, coma, nausea, vomiting, abdominal pain, loss of appetite, and rash. Sometimes no symptoms at all.

- Treatment depends on the cause of injury and may include discontinuation of the drug is said to be the culprit, additional services for the body, increasing blood flow to the kidneys. It is possible for a diuretic to increase urine production if the total amount of water in the body too much. It is possible for drugs to balance the chemical composition of the blood.

- If the kidneys do not recover and the treatment does not replace a proper way of loss of kidney function, patients will need regular dialysis or kidney transplant preparation.

Symptom expression

Here are some of the symptoms can occur in people with acute renal failure. Some people have no symptoms, at least in the early stages of the disease. The symptoms can be very vague.
- Reduced urine production

- Consistent body

- Problems of concentrated urine

- Confusion

- Fatigue

- Slaughterhouses

- Nausea, vomiting

- Diarrhea

- Abdominal pain

- There is a metallic taste in the mouth

Coma may occur in severe cases of acute renal failure.
Examinations and tests
Many people with acute renal failure without symptoms. Even with non-specific symptoms, it also, which means that symptoms can be caused by many different causes. Examination often provide little unusual.
Renal failure is usually detected through blood or urine tests. These tests can be done when the patient to the hospital for other reasons, because they do not feel well but do not understand why, or in a periodic health examination.
- Concentration of urea (BUN - blood urea nitrogen) and creatinine in renal failure due to causes before kidney. This condition is called blood urea increased.
- The concentration of electrolytes in the blood may be high or unusually low due to the kidney's filtering function is not normal.

- When persistent and severe renal impairment, the number of red blood cells can be reduced, as well as anemia.

Can measure the amount of urine excreted in a certain period of time to know the quantity and quality of the waste is released. When renal parenchymal damage, protein and other substances that can be excreted through the urine an unusual way. In some cases, the amount of urine left in the bladder after urination can be measured by placing a catheter (a thin rubber tube) into the bladder.
- The urine left in the bladder after urination may suggest a renal failure after kidney, usually due to an enlarged prostate in men

- Dark urine can indicate the status of creatinine and other substances condense.

- Urine can be viewed under a microscope to detect specific signs of kidney disease. Some signs include blood, pus, urine and solid inside.

- The concentration of electrolytes in the urine can help determine the exact cause of kidney failure.

If no definite diagnosis after tests, renal and bladder ultrasound to find out the sign of the specific causes of kidney failure.
In some cases, a sample of kidney tissue is removed to find the cause of renal failure.
Treatment of kidney failure depends on the cause and severity of the disease. Patients can be transferred to a specialist urologist for treatment. The first objective is to determine the exact cause of kidney failure to guide treatment. Then, determine the extent of affecting the body of water and waste products accumulate to adjust treatment decisions in selecting drugs and dialysis.
Home care
In acute renal failure should not stay in the home for self-treatment as this can be a severe illness requires the care of doctors.
- This can be done at home part or all of the therapies. In some cases can be treated at home by a nurse under the supervision of the family doctor.

- In the case of recovery of renal function is not absolutely necessary to use artificial kidney to remove excess water and waste products accumulate. Can do this by dialysis, is a process of filtering waste products and water from the blood. Dialysis was carried out at the hospital when needed. Can be done at home in the case of permanent kidney failure and dialysis for the rest of his life.


Treatment focuses on eliminating the cause of renal failure.
Need to check the drug and what the patient has to digest. Any substance that can cause damage to the kidneys will eliminate or reduce the dose.
The other treatment will be offered with the following objectives:
- Treatment of dehydration - communication solution intravenously, together with electrolytes if necessary.

- Prevents service - for what kind of kidney failure kidney excess fluid being eliminated properly.

- Increased blood flow to the kidneys - often by improving cardiac function or hypertension.

- Treatment of chemical abnormalities (electrolytes) to help the other organ systems of the body work normally.

If the kidneys of patients do not respond to treatment and renal function can not be restored properly, patients need dialysis. Dialysis is done by way of the blood vessels (hemodialysis) or by way of access to the abdominal cavity through the membrane that surrounds the organs of the abdominal cavity (peritoneal dialysis).
- For hemodialysis, the patient is connected to the machine through a tube running inside the tube is created surgically between large arteries and veins. Artificial blood passes through the kidneys and will remove toxins and waste products out and then go back to the body.

- Most patients require dialysis three times a week

For peritoneal dialysis, waste products and excess water from the blood moves into the abdominal cavity (peritoneal cavity) and will be eliminated from the body through a catheter placed into the body through surgery (through the skin) to go into the peritoneal cavity.
Many patients can improve health when the causes of kidney failure are removed or treated and do not require dialysis. Normal kidney function will be restored to normal, although in some cases the lesions remaining kidney can only recover part of their normal function. These patients may not require dialysis, but need to use drugs to support kidney function is lost.
The next step


Your doctor will arrange for the next re-examination in accordance with causes of kidney failure and the severity of the disease. Then the patient will be monitored condition caused his kidney failure and perform the necessary tests to ensure that kidney function was restored. Preventive measures may be necessary in some cases to prevent the disease from recurring again.
Annual health checks including blood tests and urinalysis to monitor the status of the kidney and urinary tract.
Drink enough water to help your kidneys work normally.
Avoid using toxic substances or drugs can cause or renal parenchymal damage. Ask your doctor about these substances should be avoided.
People who are at risk of chronic renal failure need to check more often on renal function and other problems can cause kidney dysfunction. If you have difficulty urinating or blood in the urine, you should go to the doctor as soon as possible.
The level of recovery of acute renal failure depends on the cause. If the cause is not from damage to the kidney tissue, the patient may be able to recover completely. Only partial recovery of renal function if the damage can not be cured completely.