What Are the 3 Types of Acute Renal Failure?

Acute renal failure (ARF), also called acute kidney injury (AKI) or acute kidney failure, is a condition in which there is a sudden loss of kidney function over a short period such as a few hours or a few days.

• ARF is a serious medical condition but is often reversible with appropriate and timely treatment.
• This is particularly seen in people with previously healthy kidneys who received treatment in the early stages.

In some cases, however, ARF can progress to cause further kidney damage leading to chronic kidney disease or chronic renal failure.

ARF can happen to anyone although it is more common in hospitalized people especially those requiring intensive care.

Some conditions may increase your risk of getting ARF, such as:

• Older age (65 years and above)
• High blood pressure
• Pre-existing kidney diseases
• Chronic conditions such as diabetes, heart diseases, and liver diseases
• Polycystic kidney disease

The symptoms of acute renal failure (ARF) may vary depending upon the cause. Some people may not have any symptoms initially and may be diagnosed based upon blood tests done for some other reason.

The symptoms of ARF may include:

• Decreased urine frequency or not passing any urine
• Swelling particularly on the feet or legs
• Weakness or fatigue
• Blood in urine
• Dark brown urine
• Nausea and vomiting
• Reduced appetite
• Pain in the abdomen or back
• Muscle cramps
• Chest discomfort or pain
• Breathing difficulty
• Confusion
• Seizures
• Unconsciousness or coma

The diagnosis of acute renal failure (ARF) will be done by your doctor based upon:

• Medical history: Your doctor will take a detailed history concerning
  • any illnesses you have (such as previous kidney diseases, diabetes, or high blood pressure)
  • any medications you are on
  • drug abuse including alcohol abuse
  • heavy metal exposure
  • investigations in the past using dyes such as contrast-enhanced computed tomography (CT) or magnetic resonance imaging scan
  • any allergies
  • other relevant information
• Physical examination: Your doctor will perform a detailed examination including examining the
  • Abdomen: To look for any palpable lump or mass, prominent veins, distension, etc.
  • Feet: To look for swelling, prominent blood vessels, etc.
  • Eyes: To examine any blood clots, inflammation, jaundice, etc.
  • Chest: To examine the presence of any abnormal heart sounds or murmurs and respiratory sounds
  • Ears: To look for any ulcers (may occur in conditions such as Wegener granulomatosis) or hearing loss (may occur in certain drug toxicities or hereditary conditions)
  • Skin: To look for any rashes, paleness, yellowing, etc.
• Blood tests: These include
  • Kidney function test to estimate blood levels of urea, creatinine, blood urea nitrogen, and serum proteins
  • Complete blood count 
  • Peripheral smear
  • Serologic tests
  • Complement testing
• Other diagnostic tests: These include
  • Urine tests to look for any blood cells, proteins, or other findings in the urine
  • Imaging studies such as ultrasound, CT scan, and X-ray
  • Biopsy (a small piece of tissue is collected from the kidney and examined under the microscope)
  • Other investigations such as electrocardiogram, bladder pressure assessment, and angiography

Based upon the investigations, ARF may be divided into different stages to ascertain its severity and plan proper treatment.

The treatment of acute renal failure (ARF) mainly depends on the severity of the disease and its cause. For example, if any medications are responsible for ARF, your doctor will stop those medications and prescribe a relevant replacement.

If kidney stones or blood clots caused the disease, your doctor will give medications or perform surgery to remove them. If an infection is present, your doctor will prescribe appropriate antibiotics for its treatment.

The treatment generally includes:

• Medications
• Fluid and electrolyte replacement
• Renal replacement therapy or dialysis (hemodialysis or peritoneal dialysis) to remove toxins and waste products from your body and give your kidneys time to heal