Symptoms and Signs of Acute Kidney Failure

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Medically Reviewed on 8/10/2021

Doctor's Notes on Acute Kidney Failure: Causes & Symptoms

Acute kidney failure (also termed renal failure or ARF) occurs when the kidneys rapidly lose their ability to filter water and waste from the blood. In the early stages of acute kidney failure, there may be little or no symptoms or signs produced. However, signs and symptoms of acute kidney failure usually come about quickly and are as follows: decreased energy that leads to a decrease in the ability to do normal activities, puffiness or swelling in the legs and around the eyes, shortness of breath, nausea and/or vomiting, diarrhea, abdominal pain, decreased or lack of urine production, lightheadedness, confusion, itching, easy bruising, metallic taste in the mouth, and elevated blood pressure. Acute complete loss of kidney function results in a medical emergency and usually produces the symptoms mentioned above with resultant seizures, coma, or death if not treated quickly. Causes of acute kidney failure can be categorized as prerenal, renal, and post-renal.

Prerenal causes usually affect the flow of blood to the kidneys. They include dehydration, drop in blood pressure, blood loss, blockage or narrowing of kidney blood vessels, heart failure, liver failure, and/or heart attacks.

Renal failure problems are due to problems with the kidney itself that prevent proper filtration of blood and/or production of urine. They include blood vessel disease within the kidney, blood clots within the kidney injuries to the kidney tissue and cells, glomerulonephritis (damage to the initial filtration system), acute interstitial nephritis (inflammation of kidney tissue that handles saltwater balance), acute tubular necrosis (damage or death of the renal tubules that perform the kidneys filtration function), and polycystic kidney disease (a genetic disorder characterized by numerous cysts in the kidneys).

Postrenal failure causes are due to problems affecting the movement of urine out of the kidneys. They include kidney stone formation, cancer of the urinary tract, some medications, bladder stones, blood clots in the bladder, bladder cancer, enlarged prostate, urethral strictures, and nerve disorders that damage the bladder's ability to empty.

What Are the Treatments for Acute Kidney Failure (ARF)?

ARF is an acute problem that needs immediate care by medical caregivers to (1) allow the kidneys to begin to heal and recover better function or (2) to save the kidneys before they cease to function. The standard care for ARF may involve one or more of the following treatments:

  • IV fluids to treat dehydration
  • Vasopressor drugs to raise blood pressure
  • Diuretics to increase urine output
  • Ureteral stent to bypass urine blockage
  • Hemodialysis
  • Peritoneal dialysis
  • Kidney transplant

Treatments should include any interventions that address underlying problems that cause ARF like cancers, nephritis, or others listed above.

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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.