Acute Kidney Failure

• Pathophysiology:

  • Directly reduced blood flow into the kidney or inflammation and necrosis of the tubules cause obstruction and back pressure, leading to greatly reduced GFR and oliguria or anuria
  • Both kidneys must be involved
  • Usually reversible if the primary problem is treated successfully
  • Dialysis may be used to replace the kidney function during this period
  • Kidneys sustain a degree of permanent damage (in some cases)
• Etiologies:

  • Acute bilateral kidney disease
  • Severe and prolonged circulatory shock or heart failure, which results in tubule necrosis
  • Burns, crash injuries, or sepsis
  • Nephrotoxins such as drugs, chemicals, or toxins
  • Calculi, blood clots, or tumors (occasionally)
• Clinical Manifestations:

  *Onset is sudden and acute

  Early signs:

  • Oliguria, increased serum urea

  Progressive signs:

  • Recovery - increasing urine output
  • If prolonged failure - uremia
• Risk Factors:

  • Heart disease
  • Obesity
  • Family history
  • Inherited kidney disorders
  • Past damage to the kidneys
  • Older age