Acute kidney failure or acute kidney injury is a condition when the kidneys stop functioning suddenly. This condition can be caused by impaired blood flow to the kidneys, kidney disorders, or problems with blockages in the urinary tract.
Kidneys are organs that have the main function of filtering metabolic waste from the blood and removing it through urine. If this function stops, the waste that should be removed actually accumulates in the body.
Kidney damage in acute kidney failure can occur suddenly. This condition can endanger the life of the sufferer. However, if detected and treated quickly and appropriately, kidney damage from acute kidney failure can be cured.
Causes of Acute Kidney Failure
The causes of acute kidney failure are very diverse, ranging from impaired blood flow to the kidneys (prerenal), damage to the kidneys themselves, or obstruction to the flow of urine (postrenal). Here is the explanation:
Impaired blood flow to the kidneys
There are several diseases and conditions that can block blood flow to the kidneys and lead to kidney failure, namely:
- Blood or fluid loss due to bleeding, severe dehydration, or severe diarrhea
- Operation
- Sepsis or anaphylaxis
- Liver disease, such as liver cirrhosis
- Heart disease, such as heart failure or heart attack
- Severe burns
- Take medications, such as aspirin, ibuprofen, naproxen, or antihypertensive drugs
Kidney damage
Acute kidney failure can also occur due to injury or damage to the kidneys themselves, for example due to:
- Glomerulonephritis or inflammation of the filters in the kidneys
- Rhabdomyolysis or damage to muscle tissue
- Cholesterol buildup that blocks blood flow to the kidneys
- Blood clots in the veins and arteries in the kidneys
- Scleroderma, which is a group of diseases that attack the skin and connective tissue
- Hemolytic uremic syndrome, which is a disease caused by red blood cells breaking down too quickly
- Tumor lysis syndrome, which is the destruction of tumor cells resulting in the release of toxins that cause kidney damage
- Use of drugs, such as aminoglycoside antibiotics, nonsteroidal anti-inflammatory drugs (NSAIDs), hypertension drugs (such as ACE inhibitor or diuretics) and chemotherapy drugs
- Use of contrast fluid, which is the fluid used for X-rays or CT scans
- Severe infections, such as Weil's disease due to leptospirosis
- Exposure to toxins, alcohol, cocaine or heavy metals
Blockage in the urinary tract
A blockage in the urinary tract, including the renal pelvis, ureter, bladder, or urethra, will cause fluid to return to the kidneys. This condition will damage the kidneys and can cause acute kidney failure. Some diseases that can block the urinary tract are:
- Kidney stones
- Tumors in the urinary tract, kidneys, or organs around the kidneys
- Enlargement of the prostate
- Stricture or connective tissue in the urinary tract
- Bladder nerve damage (neurogenic bladder)
- Side effects of surgery on the pelvis
- Thrombosis of the renal veins
Risk Factors for Acute Kidney Failure
There are several factors that can increase a person's risk of developing kidney failure, namely:
- 65 years and over
- Are undergoing chemotherapy or other intensive care
- Have you had kidney failure before?
- Have a family history of kidney disease
- Have cancer or are undergoing cancer treatment
- Have kidney disease or have had kidney failure before
- Suffering from diabetes, hypertension, heart failure, liver disease, peripheral artery disease or obesity
Symptoms of Acute Kidney Failure
Symptoms of acute kidney failure can appear days or even hours after kidney failure occurs. Symptoms include:
- Decreased amount and frequency of urine
- Swelling of the legs due to fluid buildup
- Body tired easily
- Hard to breathe
- Heart rhythm disturbances
- Pain or a feeling of pressure in the chest
- Bad breath
- A rash or itching appears on the skin
- Decreased appetite
- Nausea and vomiting
- Fever
- Pain in stomach and back
- Pain or swelling in the joints
- Tremor in hand
- Seizures
- Coma
When to go to the doctor
Go to the emergency room immediately if you experience symptoms of acute kidney failure, especially if you have had kidney failure or have a family history of kidney disease.
Check with your doctor regularly if you suffer from chronic diseases that can cause acute kidney failure, such as hypertension and diabetes.
To prevent the occurrence of acute kidney failure due to the use of drugs, do not take drugs carelessly and always follow the rules given by the doctor.
Diagnosis of Acute Kidney Failure
The doctor will ask about the symptoms experienced and the patient's medical history, then proceed with a physical examination. Next, the doctor will carry out supporting examinations which include:
- Blood tests, to measure creatinine and urea nitrogen levels which will increase in acute kidney failure, as well as to measure the glomerular filtration rate (GFR)glomerular filtration rate) to assess the severity of acute renal failure
- Urine test, to measure electrolyte levels in urine and measure the volume of urine that comes out
- Scans with ultrasound, CT scan, or MRI, to see the condition of the kidneys and detect the presence or absence of tumors or blockages in the urinary tract or blood vessels to the kidneys
- Kidney biopsy, to detect abnormalities in kidney tissue
Treatment of Acute Kidney Failure
Treatment of acute kidney failure aims to prevent complications and restore kidney function. Patients usually need to be hospitalized the length of which depends on how severe the condition is and how quickly the kidneys are able to recover.
The method of treatment of acute renal failure depends on the cause. Some of the treatment methods that can be given by doctors are:
- Dietary regulation, namely by limiting the consumption of foods high in salt and potassium during the kidney healing process
- Giving drugs, namely by giving drugs that can balance electrolyte levels in the blood, giving diuretics to remove excess fluid, antibiotics if kidney failure is caused by a bacterial infection
- Dialysis, which is a procedure performed when kidney damage is severe enough
Complications of Acute Kidney Failure
Acute kidney failure can lead to death and the following complications:
- Metabolic acidosis (increased levels of acid in the blood)
- Electrolyte imbalance
- Pulmonary edema or fluid buildup in the lungs
- Heart disease, such as heart failure, heart attack, arrhythmia, or cardiac arrest
- Digestive system disorders, including gastrointestinal bleeding
- Permanent kidney damage
- Hyperkalemia or high potassium levels
- Nerve disorders due to accumulation of urea or uremia
Prevention of Acute Kidney Failure
The way to prevent acute kidney failure is to maintain kidney health by taking the following steps:
- Eating healthy food
- Limit salt intake
- Maintain ideal body weight
- Control blood sugar levels
- Control blood pressure
- Drink enough water
- Limiting the consumption of pain relievers
- Limiting consumption of alcoholic beverages
- Quit smoking
- Manage stress well
- Exercise regularly