Frequently asked questions about Acute Renal Failure

1. Which doctor should I consult?

A Nephrologist

2. What increases my risk for Acute Renal Failure?

Acute Renal Failure (ARF) is seen more often in people already in the hospital for another serious problem.

Other risk factors include:

 Severe dehydration like in cases of severe blood loss (hemorrhage), shock, severe vomiting or diarrhea and overuse of diuretics.

 Decreased cardiac output like in heart attack, abnormal heart beats (arrthymia), high blood pressure, inflammation of heart tissue (endocarditic), disease of the heart valves.

 Other causes of circulatory disturbance like Nephrotic syndrome, advanced liver disease (cirrhosis) severe malnutrition, burns, severe injury or crushing injuries, severe infection (sepsis).

3. What is the difference between acute kidney (renal) failure and chronic kidney disease and how does my doctor come to a conclusion of what type of kidney failure is present?

To treat kidney failure effectively, it is important to know whether kidney disease has developed suddenly (acute) or over the long term (chronic). Many conditions, diseases, and medications can create situations that lead to acute and chronic kidney disease.

Acute Renal Failure (ARF) is usually caused by an event that leads to kidney malfunction, such as dehydration; blood loss from major surgery or injury; or the use of medications, such as contrast agents used in X-ray tests or antibiotics such as Gentamicin.

There are also other tablets that can cause problem with kidney or its failure, more so when there is some other disease or when given in combination with other tablets or injection.

Chronic kidney disease (CKD) is usually caused by a long-term disease, such as high blood pressure or diabetes, that slowly damages the kidneys and reduces their function over time. The presence or lack of symptoms may help your health professional determine whether Acute Renal Failure or chronic kidney disease is present. Acute form presents itself as any of the symptoms discussed above.

Symptoms of CKD may not develop until less than 10% to 15% of kidney function remains. Other problems may develop with CKD, such as anemia and increased levels of phosphates in the blood (hyperphosphatemia), along with complications caused by end-stage renal disease (ESRD). These complications often do not develop until kidney disease has been present for some time.

Also by comparing the laboratory values obtained, acute and chronic forms can be diagnosed.Ultrasonography can also be used in diagnosis.

4. What are the medications that can cause Acute Renal Failure?

a. Antibiotics, such as amino glycosides, cephalosporins, amphotericin B, bacitracin, vancomycin. etc

b. Blood pressure medications (angiotensin-converting enzyme [ACE] inhibitors) eg. captopril and ramipril.

c. Chemotherapy medications, such as cisplatin, carboplatin, and methotrexate.

d. Contrast media used in medical imaging studies.

e. Illegal "street" drugs, such as heroin and methamphetamine.

f. Medications used to treat HIV (protease inhibitors), such as indinavir and ritonavir.

g. Nonsteroidal anti-inflammatory medications, such as ibuprofen, ketoprofen, rofecoxib, and celecoxib.

h. Ulcer medications such as cimetidine.

i. Other chemicals, such as insecticides, herbicides, and ethylene glycol, can also cause ARF.

Please remember that the list of drugs may appear long but many of these medications only when given unsupervised or if given for a long period of time will cause problem.

The non steroidal anti-inflammatory drugs should not be taken without prescription and should be avoided if possible.

5. What is End Stage Renal Disease (ESRD)?

End-stage renal disease (ESRD) occurs when kidney damage is so severe that dialysis or a kidney transplant is needed to control symptoms and prevent complications and death. ESRD often occurs after kidney damage has been present for 10 years or more. Diabetes and high blood pressure are the most common causes of ESRD.

Kidney failure can be measured by how well the kidneys are able to filter wastes from the blood (Glomerular Filtration Rate, or GFR). ESRD usually occurs when the GFR falls 10% to 15% below what is expected in a person with normal kidney function.

Heart disease is the most common cause of death in people with end-stage renal disease.

6. What is Uremic syndrome?

Uremic syndrome (uremia) is a serious complication of chronic kidney disease. It occurs when urea and other waste products build up in the body because the kidneys are unable to eliminate them. These substances can become poisonous (toxic) to the body if they reach high levels. Prolonged or severe fluid buildup (edema) may make the uremic syndrome worse.

Uremic syndrome may affect any part of the body and can cause:

Nausea, vomiting, loss of appetite, and weight loss. Changes in mental status, such as confusion, reduced awareness, agitation, psychosis, seizures, and coma. Abnormal bleeding, such as bleeding spontaneously or profusely from a very minor injury. Heart problems, such as an irregular heartbeat, inflammation of and excess fluid in the sac that surrounds the heart (pericarditis), and increased pressure on the heart. Shortness of breath from fluid buildup in the space between the lungs and the chest wall (pleural effusion). Kidney dialysis is usually needed to relieve the symptoms of uremic syndrome until normal kidney function can be restored.

7. Is there any home treatment or surgery available for ARF?

There is no home treatment for Acute Renal Failure (ARF)

If there is a blockage in the urinary system (stones, tumors or abnormal prostate enlargement) it is possible to relieve him and hence improve the acute renal failure situation using some process of surgery, as such there is no surgical treatment for Acute Renal Failure (ARF). Your nephrologist may talk to you about kidney transplantation if you develop End-Stage Renal Disease (ESRD).

Dialysis

8. What is hem dialysis and how is it connected to ARF?

Hem dialysis is a mechanical process that partly performs the work of healthy kidneys. Hem dialysis uses a man-made membrane (dialyzes) to filter wastes, remove extra fluid from the blood, restore the proper balance of chemicals in the blood, and eliminate extra fluid (edema) from the body.