acute renal failure


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Related to acute renal failure: chronic renal failure

acute renal failure (ARF)

renal failure of sudden onset, such as from physical trauma, infection, inflammation, or toxicity. Symptoms include uremia and usually oliguria or anuria, with hyperkalemia and pulmonary edema. Three types are distinguished: prerenal, associated with poor systemic perfusion and decreased renal blood flow, such as with hypovolemic shock or congestive heart failure; intrarenal, associated with disease of the renal parenchyma, such as tubulointerstitial nephritis, acute interstitial nephritis, or nephrotoxicity; and postrenal, resulting from obstruction of urine flow out of the kidneys. See also renal failure.
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Causes of acute renal failure

acute renal failure

An abrupt decline in renal function, marked by a rise in serum creatinine or azotemia, triggered by various processes—e.g., sepsis, shock, trauma, kidney stones, drug toxicity (aspirin, lithium, substances of abuse), toxins, iodinated radiocontrast.

Clinical findings
• Cardiovascular
Congestive heart failure, myocardial infarction, arrhythmias, cardiac arrest occur in up to 35% of patients with ARF. The elderly with low cardiac reserve are at risk of fluid overload secondary to oliguric ARF.

• Pulmonary
Lung disease occurs in over half of patients with ARF and may be linked to shared pulmonary and renal syndromes—e.g., Goodpasture syndrome, Wegener granulomatosis, polyarteritis nodosa, cryoglobulinemia, sarcoidosis. Hypoxia is common during hemodialysis and attributed to white cell sequestration by the lungs and alveolar hypoventilation.

• GI tract
Nausea, vomiting, anorexia; GI bleeding occurs in ± one third of patients with ARF and causes nearly 10% of deaths in patients with ARF. Other GI complaints include pancreatitis, jaundice linked to hepatic congestion, blood transfusions, and sepsis.

• Infections
Occur in up to 33% of patients with ARF; most occur in the lungs and urinary tract, and have mortality rates of up to 72%.
 
• Neurologic signs of uraemia occur in one-third of ARF patients, and have the expected findings of lethargy, somnolence, reversal of the sleep-wake cycle, and cognitive or memory deficits.

Types
• Prerenal—adaptive response to volume depletion and hypotension.
• Renal/intrinsic—response to cytotoxicity, ischaemia, or inflammation with structural and functional damage to the renal parenchyma.
• Postrenal—obstruction to the passage of urine.

Acute renal failure by type
Crescentic GN—renal vasculitis, anti-GBM disease, immune complex diseases.
Acute tubular injury—ischaemic, toxic, crystals, myoglobinuria
Acute tubulointerstitial nephritis.
Thrombotic microangiopathy—haemolytic-uraemic syndrome, accelerated hypertension, scleroderma.

acute renal failure

Acute kidney failure Nephrology An abrupt decline in renal function, triggered by various processes–eg, sepsis, shock, trauma, kidney stones, drug toxicity-aspirin, lithium, substances of abuse, toxins, iodinated radiocontrast. Cf Chronic kidney failure.

a·cute re·nal fail·ure

(ARF) (ă-kyūt' rē'năl fāl'yŭr)
A rapid decline of kidney function due to tubular injury. Signs are azotemia, fluid and electrolyte imbalance, and metabolic acidosis. Commonly caused by ischemia or nephrotoxins.
References in periodicals archive ?
Drugs profile discussed in this report include adrecizumab, BB-3, BBT-030, BBT-045, CAB-101, cardiotrophin-1, Cell Therapy to Activate Wnt7b for Kidney Injury, CXA-10, DM-199, HYPER-IL-6, KP-100IT, MTP-131, N-003, NOXD-21, NYK-1341, OPN-305, Pyridoxamine Dihydrochloride, QPI-1002, R-190, Recombinant Human Alkaline Phosphatase, RO-6839328, Small Molecule to Activate Heat Shock Protein 70 (Hsp70) for Delayed Graft Function, Small Molecule to Inhibit CDK4 and CDK6 for Acute Kidney Injury and Breast Cancer, Small Molecule to Inhibit HDAC for Acute Kidney Injury, Small Molecules for Acute Renal Failure, STSE-15, THR-184, TRC-160334.
As in the Baltimore (30) and London (31) cohorts, poor HIV control raised chances of acute renal failure in the North Carolina group (32)--specifically a CD4 count below 200 cells/[mm.
Acute renal failure in vivax malaria may also be a manifestation of severe systemic inflammatory response syndrome as happens in sepsis (30-31).
Initial laboratory results reflected infection, metabolic acidosis, hyperkalemia, and acute renal failure.
Acute renal failure or injury is a common post-operative complication and has a significant impact on the survival of patients undergoing heart surgery.
A comparison of inpatient length of stay and costs among patients with hematologic malignancies (excluding Hodgkin disease) associated with and without acute renal failure.
In the group of patients that had uMb measurement (n = 1341), 581 were positive for uMb and 745 developed acute renal failure.
45,46) A risk of myopathy and rhabdomyolysis with subsequent acute renal failure has been shown (45,46); however, most cases of rhabdomyolysis occur at higher doses than are typically prescribed, such as the 80-mg dose of rosuvastatin, which has been discontinued.
Decreasing incidence of renal cortical necrosis in patients with acute renal failure in developing countries: a single centre experience of 22 years from Eastern India.
The writer was taken to Germany on May 19 with septic shock, double pneumonia, acute renal failure.

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