Acute kidney failure

It is the rapid loss (in less than 2 days) of the ability of your kidneys to remove waste and help with the balance of fluids and  electrolytes  in the body.

Causes
There are numerous possible causes of damage to the kidneys. These include:

Acute tubular necrosis ( NTA )
Autoimmune renal disease
Blood clot by cholesterol (cholesterol plunger)
Decreased blood flow due to very low blood pressure, which can result from burns , dehydration , bleeding, injury, septic shock , severe illness or surgery
Disorders that cause clotting within the blood vessels of the kidney
Infections that cause injury directly to the kidney such as acute pyelonephritis , septicemia
Complications of pregnancy, including premature detachment of placenta or placenta previa
Obstruction of the urinary tract
Illegal drugs such as cocaine and heroin
Medications including non-steroidal anti-inflammatory drugs (NSAIDs), certain antibiotics and blood pressure medications, intravenous contrast agents, and some drugs for cancer and HIV.
symptom
Symptoms of acute renal failure may include any of the following:

Bloody Stools
Bad breath  and metallic taste in the mouth
Tendency to the formation of bruises
Changes in mental state or mood
Inapetencia
Decreased sensitivity , especially in the hands or feet
Fatigue  (tiredness)
Pain in the side (between the ribs and the hips)
Trembling in the hand
Heart murmurs
Arterial hypertension
Nausea or vomiting that can last days
Nosebleed
Persistent hiccough
Prolonged bleeding
Epileptic seizure
Difficulty breathing
Swelling  from fluid retention in the body (may occur in the legs, ankles, and feet)
Changes in urination as little or no urination, excessive urination at night or complete voiding discontinuation
Tests and exams
Your health care provider will examine you.

Tests to see how well your kidneys are working include:

BUN
Creatinine clearance
Creatinine in serum
Potassium in serum
Urine analysis
Other blood tests may be done to find the underlying cause of kidney failure.

A renal or abdominal ultrasound is the preferred test to diagnose a blockage in the urinary tract. X-rays, computed tomography (CT), or MRI of the abdomen may also indicate if there is an obstruction.

Treatment
Once the cause is found, the goal of treatment is to restore the functioning of the kidneys and prevent fluid and waste from accumulating in the body as these organs heal. It is usually necessary to stay overnight in the hospital for treatment.

The amount of fluid you drink will be limited to the amount of urine you can produce. They will tell you what you can or can not eat in order to reduce the accumulation of toxins that the kidneys would normally eliminate. You may need to eat a diet rich in carbohydrates and low in protein , salt and potassium .

Antibiotics may be needed to treat or prevent infection. Diuretics may be used to help remove fluid from the body.

Intravenous medications will be given to help control potassium levels in the blood.

You may need dialysis . This is a treatment that does what the kidneys normally do: remove harmful waste, extra salt and water from the body. Dialysis can save your life if potassium levels are dangerously high. Dialysis will also be used if:

Your mental state changes
Presents pericarditis
Retains too much liquid
Can not remove nitrogenous waste products from the body
Dialysis will almost always be for a short time. In rare cases, kidney damage is so great that dialysis may be needed on a permanent basis.

When to Contact a Medical Professional
Call your healthcare provider if your urine output decreases or stops or if you have other symptoms of acute kidney failure.

Prevention
To prevent acute renal failure:

Health problems such as high blood pressure or diabetes should be well controlled
Avoid drugs and medications that can cause kidney damage.
Alternate Names
Insufficiency of the kidney; Renal insufficiency; Acute renal failure; GO TO; Acute kidney injury

References
Devarajan P. Biomarkers for assessment of renal function during acute kidney injury. In: Alpern RJ, Moe OW, Caplan M, eds. Seldin and Giebisch's The Kidney . 5th ed. Philadelphia, PA: Elsevier; 2013: chap 75.