Acute Kidney / Renal Failure (AKI)

Acute kidney failure happens when your kidneys suddenly lose the ability to eliminate excess salts, fluids, and waste materials from the blood. This elimination is the core of your kidneys’ main function. Body fluids can rise to dangerous levels when kidneys lose their filtering ability. The condition will also cause electrolytes and waste material to accumulate in your body, which can also be life-threatening.

Acute kidney failure is also called acute kidney injury or acute renal failure. It’s common in people who are already in the hospital. It may develop rapidly over a few hours. It can also develop over a few days to weeks. People who are critically ill and need intensive care have the highest risk of developing acute kidney failure.

Acute kidney failure can be life-threatening and requires intensive treatment. However, it may be reversible. If you’re in good health otherwise, recovery is possible.

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Acute kidney failure can occur for many reasons. Among the most common reasons are:

  • acute tubular necrosis (ATN)
  • severe or sudden dehydration
  • toxic kidney injury from poisons or certain medications
  • autoimmune kidney diseases, such as acute nephritic syndrome and interstitial nephritis
  • urinary tract obstruction

Reduced blood flow can damage your kidneys. The following conditions can lead to decreased blood flow to your kidneys:

  • low blood pressure
  • burns
  • dehydration
  • hemorrhage
  • injury
  • septic shock
  • serious illness
  • surgery

Certain disorders can cause clotting within your kidney’s blood vessels, and this can lead to acute kidney failure. These conditions include:

  • hemolytic uremic syndrome
  • idiopathic thrombocytopenic thrombotic purpura (ITTP)
  • malignant hypertension
  • transfusion reaction
  • scleroderma

Some infections, such as septicemia and acute pyelonephritis, can directly injure your kidneys.

Pregnancy can also cause complications that harm the kidneys, including placenta previa and placenta abruption.

The chances of acquiring acute kidney failure are greater if you’re an older person or if you have any of the following long-term health problems:

  • kidney disease
  • liver disease
  • diabetes, especially if it’s not well controlled
  • high blood pressure
  • heart failure
  • morbid obesity

If you’re ill or being treated in a hospital’s intensive care unit, you’re at an extremely high risk for acute kidney failure. Being the recipient of heart surgery, abdominal surgery, or a bone marrow transplant can also increase your risk.

The symptoms of acute kidney failure include:

  • bloody stools
  • breath odor
  • slow, sluggish movements
  • generalized swelling or fluid retention
  • fatigue
  • pain between ribs and hips
  • hand tremor
  • bruising easily
  • changes in mental status or mood, especially in older adults
  • decreased appetite
  • decreased sensation, especially in your hands or feet
  • prolonged bleeding
  • seizures
  • nausea
  • vomiting
  • high blood pressure
  • a metallic taste in your mouth

If you have acute kidney failure, you may have generalized swelling. The swelling is due to fluid retention.

Using a stethoscope, your doctor may hear crackling in the lungs. These sounds can signal fluid retention.

Results of laboratory tests may also show abnormal values, which are new and different from baseline levels. Some of these tests include:

  • blood urea nitrogen (BUN)
  • serum potassium
  • serum sodium
  • estimated glomerular filtration rate (eGFR)
  • urinalysis
  • creatinine clearance
  • serum creatinine

An ultrasound is the preferred method for diagnosing acute kidney failure. However, abdominal X-ray, abdominal CT scan, and abdominal MRI can help your doctor determine if there’s a blockage in your urinary tract.

Certain blood tests may also reveal underlying causes of acute kidney failure.

Your treatment will depend on the cause of your acute kidney failure. The goal is to restore normal kidney function. Preventing fluids and wastes from building up in your body while your kidneys recover is important. In the majority of cases, a kidney specialist called a “nephrologist” makes an evaluation.


Your doctor will restrict your diet and the amount of liquids you eat and drink. This will reduce the buildup of toxins that the kidneys would normally eliminate. A diet high in carbohydrates and low in protein, salt, and potassium is usually recommended.


Your doctor may prescribe antibiotics to treat or prevent any infections that occur at the same time. Diuretics may help your kidneys eliminate fluid. Calcium and insulin can help you avoid dangerous increases in your blood potassium levels.


You may need dialysis, but it’s not always necessary, and it will likely only be temporary. Dialysis involves diverting blood out of your body into a machine that filters out waste. The clean blood then returns to your body. If your potassium levels are dangerously high, dialysis can save your life.

Dialysis is necessary if there are changes in your mental status or if you stop urinating. You may also need dialysis if you develop pericarditis or inflammation of the heart. Dialysis can help eliminate nitrogen waste products from your body.

Preventing and treating illnesses that can lead to acute kidney failure is the best method for avoiding the disease. Having a healthy lifestyle that includes regular physical activity and a sensible diet can help to prevent kidney failure. Work with your doctor to manage existing medical conditions that could lead to acute kidney failure.

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