What is Acute Kidney Failure?
It is defined as a rapid deterioration in renal functions sufficient to result in an accumulation
of waste products in the body.
Causes
1. Kidney failure due to diseases in other organs:
a. Decreased water volume of the body through the skin, digestive system, hemorrhage,
severe burns, inflammation of the pancreas, and the peritoneum.
b. Heart failure e.g. heart attacks, shock, blood poisoning and drugs.
2. Kidney diseases:
a. Blood vessel disease: Inflammation of the blood vessels, high BP, certain blood
disorders, arterial and venous obstruction.
b. Infection of the glomeruli of the kidneys.
c. Infection of the kidney tissue.
d. Kidney infarction.
e. Toxins: antibiotics, anesthetic agents, heavy metals.
f. Pregnancy-related: septic abortion, uterine hemorrhage, eclampsia.
g. Others: Transfusion reaction, trauma, heatstroke.
Fundamentally there is a gross reduction in the filtration of blood due to a marked reduction
in surface area available for filtration. Filtration pressure and water pressure are reduced.
Clinical Features
1. Less urine formation (oliguria) is the cardinal feature. Urine volume is less than 400 mil
per day.
2. Blood urea (a waste product) rises, blood potassium rises.
3. Salt and water overload leading to edema (excessive water collection independent
tissues) and pulmonary congestion.
4. Infections complicate up to 70% of cases.
5. Heart: High BP, irregular heartbeats due to excessive potassium in the blood.
6. Nervous system abnormalities: Lethargy, excessive sleepiness, confusion, disorientation,
agitation, muscle twitches, convulsions. All this is due to excess blood urea and brain
chemistry changes.
7. Digestive system: Nausea and vomiting.
Management
Admit for specialised treatment and dialysis.