Acute Kidney Failure

What is acute kidney failure?

Acute kidney failure occurs when one or both of your kidneys suddenly stop working. Acute kidney failure is also called acute renal failure (ARF). Normally, the kidneys remove chemicals and waste from the blood. These wastes are turned into urine by the kidneys. In acute kidney failure, your kidneys can no longer do this.

What causes acute kidney failure?

Acute kidney failure usually occurs because of the following illnesses or injuries:

  • Diabetes: High blood sugar can damage your kidneys.

  • Genetics: You have a greater risk for acute kidney failure if you have a parent or sibling with kidney disease.

  • High blood pressure: High blood pressure may damage the blood vessels inside your kidneys.

  • Medicine or chemical exposure: You may have a higher risk if you use certain medicines. Ask your caregiver if any of the medicines you take could cause acute kidney failure. Dyes used in various x-rays may also increase your risk of acute kidney failure.

  • Sepsis: This is a severe infection of the blood caused by germs, such as bacteria and viruses.

  • Trauma: Shock and severe bleeding from surgery or injury can cause acute kidney failure.

  • Other health problems:

    • Dehydration caused by burns, severe vomiting, or diarrhea

    • Low blood pressure due to surgery, heart failure, or blood loss

    • Liver disease, which can affect blood flow and blood pressure to the kidneys

    • Other kidney diseases, such as stones, repeated kidney infections, or cancer

    • Autoimmune diseases, such as lupus

What are the signs and symptoms of acute kidney failure?

  • Changes in your urine: You may urinate less or not at all. Your urine may be pink or red.

  • Swelling: Your face, arms, legs, or feet are swollen, or you have rapid weight gain.

  • Back pain: You have middle to lower back pain.

  • Changes in your blood pressure: You may feel dizzy when you stand up. Your blood pressure may be higher or lower than usual when you check it.

  • Changes in your appetite: You have nausea and vomiting, or a bitter or metallic taste in your mouth.

  • Low energy: You feel tired and weak most of the time. You may find it difficult to concentrate.

  • Other: Your skin feels dry and itchy, or you may bruise easily. You may also have shortness of breath, faint, or have a seizure.

How is acute kidney failure diagnosed?

  • Blood and urine tests: These tests will show how well your kidneys are working.

  • Imaging tests: The following tests may be used to take pictures of your kidneys:

    • Renal ultrasound: This is a test using sound waves to look at your kidneys. Pictures of your kidneys show up on a TV-like screen. A renal ultrasound can show if you have kidney stones, an abscess, or other problems.

    • KUB x-ray: An x-ray machine takes pictures of your kidneys (K), ureters (U), and bladder (B). The ureters are tiny tubes that carry urine from your kidneys to your bladder. The bladder is where the urine is stored before leaving your body. Caregivers use these pictures to check for problems with your intestines , kidneys, or abdomen.

    • CT: A type of x-ray machine uses a computer to take pictures of your kidneys. You may be given dye in your IV before the pictures are taken. The dye may help caregivers see the pictures better. People who are allergic to iodine or shellfish (crab, lobster, or shrimp) may be allergic to some dyes. Tell the caregiver if you are allergic to shellfish, or have other allergies or medical conditions.

    • MRI: An MRI may be used to take pictures of your kidneys. The MRI machine contains a very powerful magnet. Never enter the MRI room with any metal objects. This can cause serious injury. Tell your caregiver if you have any metal implants in your body.

  • Biopsy: A very small piece of your kidney is removed and tested during this surgical procedure.

How is acute kidney failure treated?

Treatment depends upon the cause of your kidney failure and how severe it is. You may need any of the following:

  • Medicines:

    • Diuretics: These medicines are often called water pills. Diuretics help your body get rid of extra fluid. Diuretics may also decrease your blood pressure.

    • Blood pressure medicine: This is given to lower your blood pressure. A controlled blood pressure helps protect your kidneys.

    • Steroids: This medicine decreases inflammation and pain.

  • Other treatments: You may have any of the following treatments if medicines do not control your kidney failure:

    • Dialysis: This cleans your blood of wastes when your kidneys no longer work well.

    • Surgery: You may need surgery if your kidney failure is caused by a blockage in your urinary system.

    • Kidney transplant: This is surgery to replace your failed kidney with a healthy kidney donated by another person. The donated kidney does the work that your failed kidneys used to do.

What are the risks of acute kidney failure?

Treatment for acute kidney failure may cause unpleasant side effects. You could get an infection or bleed too much during or after surgery. If acute kidney failure is not treated, it can be life-threatening. The risk of serious illness or death is much lower if acute kidney failure is treated early.

When should I contact my caregiver?

Contact your caregiver if:

  • You have a fever.

  • You have chills, cough, or feel weak and achy.

  • Your skin is itchy or you have a rash.

  • You have questions or concerns about your condition or care.

When should I seek immediate help?

Seek help immediately or call 911 if:

  • You are breathing fast, have a fast heart beat, or feel confused, dizzy, or lightheaded.

  • You are urinating very little or not at all.

  • You cannot eat or drink because you are vomiting.

  • You have sudden chest pain or trouble breathing.

Where can I find support and more information?

  • National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
    Building 31, room 9A04 Center Drive, MSC 2560
    Bethesda , MD 208922560
    Web Address:
  • American Association of Kidney Patients
    3505 E. Frontage Rd, Suite 315
    Tampa , FL 33607-1796
    Phone: 1- 800 - 749-2257
    Web Address:

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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