Acute Kidney Failure Overview
The kidneys are a pair of small (about the size of your fist) bean-shaped organs that lie on either side of your spine at just below your lowest ribs. They filter by-products and toxins from your blood and preserve the balance of bodily Fluids and Electrolytes.
- The kidneys excrete these compounds with water to make urine.
- They also eliminate excess body water while reabsorbing useful chemicals and allowing waste to pass freely into the bladder as urine.
- They allow a person to consume a variety of foods, drugs, vitamins and supplements, additives, and excess fluids without worry that toxic by-products will build up to harmful levels.
- The kidneys regulate the amount of various substances in the blood and the amount of water in the body.
There are many possible causes of kidney damage. They include:
- Acute nephritic syndrome
- Interstitial nephritis
- Septic shock
- Serious illness
- Hemolytic-uremic syndrome
- Idiopathic thrombocytopenic thrombotic purpura (ITTP)
- Malignant hypertension
- Transfusion reaction
- Bloody stools
- Breath odor
- Brusing easily
- Changes in mental statusor mood
- Decreased appetite
- Decreased sensation, especially in the hands or feet
- Flank pain (between the ribs and hips)
- Hand tremor
- High blood pressure
- Metallic taste in mouth
- Nausea or vomiting, may last for days
- Persistent hiccups
- Prolonged bleeding
- Slow, sluggish movements
- Swelling - generalized (fluid retention)
- Swelling of the ankle, feet, and leg swelling
- Urination changes:
- Decrease in amount of urine
- Excessive urination at night
- Urination stops completely
Exams and Tests
Many patients have generalized swelling caused by fluid retention. The doctor may hear a heart murmur, crackles in the lungs, or signs of inflammation of the lining of the heart when listening to the heart and lungs with a stethoscope.
The results of laboratory tests may change suddenly (within a few days to 2 weeks). Such tests may include:
- Creatinine clearance
- Serum creatinine
- Serum potassium
Blood tests may help reveal the underlying cause of kidney failure. Arterial blood gas and blood chemistries may show metabolic acidosis.
Once the cause is found, the goal of treatment is to restore kidney function and prevent fluid and waste from building up in the body while the kidneys heal. Usually, you have to stay overnight in the hospital for treatment.
The amount of liquid you eat (such as soup) or drink will be limited to the amount of urine you can produce. You will be told what you may and may not eat to reduce the build-up of toxins normally handled by the kidneys. Your diet may need to be high in carbohydrates and low in protein, salt, and potassium.
You may need antibiotics to treat or prevent infection. Diuretics ("water pills") may be used to help the kidneys lose fluid. Calcium, glucose/insulin, or potassium will be given through a vein to help avoid dangerous increases in blood potassium levels.
Dialysis may be needed, and can make you feel better. It is not always necessary, but it can save your life if your potassium levels are dangerously high. Dialysis will also be used if your mental status changes, you stop urinating, develop pericarditis, retain too much fluid, or cannot eliminate nitrogen waste products from your body.
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