• decreased urine output
  • decreased urine volume(oliguria)
  • no urine output(anuria)
• urination, excessive at night(can occur in some types of renal failure)
• ankle, feet, and leg swelling
• generalized swelling, fluid retention
• decrease in sensation, especially the hands or feet
• changes in mental statusor mood
  • agitation
  • drowsiness, lethargy
  • deliriumor confusion
  • coma
  • fluctuating mood
  • difficulty paying attention (attention deficit)
  • hallucinations
• slow, sluggish, movements
• seizures
• hand tremor
• nausea, vomiting
  • may persist for days
  • morning sickness
  • vomiting blood
• prolonged bleeding, bruising easily
  • stools, bloody
  • nosebleed
  • growth, slow (child 0-5 years)
• flank pain
• fatigue
• ear noise/buzzing
• breath odor
• breast development in males
• blood pressure, high

Acute Kidney Failure Prevention :

Treating any causative disorders may help to prevent acute renal failure. Many cases may not be preventable.


Acute Kidney Failure Diagnosis & Tests :

Examination and testing can reveal acute renal failure and help rule out other disorders that affect kidney function. In this condition, there is generalized swelling caused by fluid retention. With a stethoscope, a heart murmur or other sounds related to increased fluid volume may be heard and crackles may be heard from the lungs.

Lab values may change suddenly (within a few days to 2 weeks):

• Urinalysis may be abnormal.
• Serum creatininemay increase by 2 mg/dL or more over a 2-week period.
• Creatinine clearancemay be decreased.
• BUNmay increase suddenly.
• Serum potassiumlevels may be increased.
• Arterial blood gas and blood chemistries may show metabolic acidosis.
• Kidney or abdominal ultrasound is usually the best test, but abdominal X-ray, abdominal CT scan or abdominal MRI may also reveal the cause of acute renal failure. Kidney size is usually normal or slightly large.
• Chemical tests of blood and urine may also help to distinguish the causes. A clean catch urine specimen will indicate if the cause is infection within the urinary tract. Renal angiography (renal arteriography) may be used to diagnose causes within the blood vessels of the kidney.

• 25-hydroxy Vitamin D
• amylase
• amylase, urine
• AST
• calcium (ionized)
• CO2
• creatinine - urine
• ESR
• nerve conduction velocity
• platelet aggregation test
• protein electrophoresis - urine
• RBC indices
• RT3U
• serum calcium
• serum chloride
• serum phosphorus
• serum sodium
• sodium, urine
• T4
• urea nitrogen; urine
• uric acid
• urinary casts
• urine 24h volume
• urine concentration test
• urine pH
• urine specific gravity

Acute Kidney Failure Treatment :

The goal of treatment is to identify and treat any reversible causes of the kidney failure (e.g., use of kidney-toxic medications, obstructive uropathy, volume depletion). Treatment also focuses on preventing excess accumulation of fluids and wastes, while allowing the kidneys to heal and gradually resume their normal function. Hospitalization is required for treatment and monitoring.

Your fluid intake may be severely restricted to an amount equal to the volume of urine you produce. You may be given specific dietary modifications to reduce build-up of toxins normally handled by the kidneys, including a diet plan high in carbohydrates and low in protein, salt, and potassium.

Antibiotics may be used to treat or prevent infection. Diuretics may be used to remove fluid from the kidney.

A major priority in treatment is to control dangerous hyperkalemia (increased blood potassium levels). A variety of different medications may be used, including IV (intravenous) calcium, glucose/insulin, and oral or rectal administration of potassium exchange resin (Kayexalate).

Dialysis may be used to remove excess waste and fluids. This often makes the person feel better and may make the kidney failure easier to control. Dialysis may not be necessary for all people, but is frequently lifesaving, particularly if serum potassium is dangerously high. Common symptoms that require the use of dialysis include decreased mental status, pericarditis, increased potassium levels, total lack of urine production, fluid overload, and uncontrolled accumulation of nitrogen waste products (serum creatinine > 10 mg/dl and BUN > 120 mg/dl).

Acute Kidney Failure Prognosis (Expectations) :

Although acute renal failure is potentially life-threatening and may require intensive treatment, it usually reverses within several weeks to a few months after the underlying cause has been treated.

A few people will progress to chronic renal failure and/or end-stage renal disease. Death is most common when the cause of the kidney failure is related to surgery or trauma or when it occurs in people with coexisting heart disease, lung disease or recent stroke. Old age, infection, loss of blood from the GI (gastrointestinal) tract, and progression of the kidney failure also increase the risk of death.


Acute Kidney Failure Complications :

• increased risk of infections
• gastrointestinal loss of blood
• chronic renal failure
• end-stage renal disease
• damage to the heart or nervous system
• hypertension

Acute Kidney Failure Support Groups :

The stress of having an illness can often be helped by joining a support group where members share common experiences and problems. Your local hospital or dialysis center may also have information regarding local support groups.


Consult Your Health Care Provider :

Consult your health care provider if decreased urine output or other symptoms indicate the possibility of acute renal failure.