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KIDNEY FAILURE, ACUTE

DESCRIPTION

Acute kidney failure is the sudden failure of the kidneys to function. This usually has a short, relatively severe course, but it is curable.
Appropriate health care includes:
  • Physician's monitoring of general condition, medications and treatment.
  • Surgery, if the cause can be corrected by surgery.
  • Hospitalization for fluid and electrolyte therapy and kidney dialysis (sometimes).

    SIGNS & SYMPTOMS
    Early stages:

  • Little or no urine output. Later stages:
  • Nausea, vomiting, diarrhea, and appetite loss.
  • Mental changes, including irritability, drowsiness, stupor, or coma.
  • Convulsions.
  • Severe itching.
  • High or low blood pressure.
  • Unexplained bruising, bleeding spots under the skin, or spontaneous bleeding. The symptoms of the underlying cause (see below) will also be present.

    CAUSES
    Conditions in the kidney, or in other areas of the body, that cause your child's kidneys to stop functioning. This leads to a buildup of waste products in the blood and tissues. Underlying conditions include:

  • Shock with very low blood pressure.
  • Blood poisoning (septicemia).
  • Congestive heart failure.
  • Fluid and electrolyte imbalance.
  • Blood-transfusion reaction.
  • Severe accident with extensive muscle injury.
  • Acute glomerulonephritis.
  • Multiple myeloma.
  • Obstruction of blood vessels that supply the kidney.
  • Kidney stones that obstruct both ureters or the urethra.
  • Prostate enlargement.
  • Use of certain medications, including anti-cancer drugs, kanamycin, amphotericin B, anti-convulsants, or excessive vitamin D.
  • Overdose of many poisons or drugs, especially mind-altering drugs.

    RISK FACTORS
    Having only one kidney; recent surgery; accidents with severe injuries; medical history of conditions affecting the kidney, such as diabetes or gout.

    PREVENTING COMPLICATIONS OR RECURRENCE

    No specific preventive measures. Your child should avoid causes and risk factors when possible.

    BASIC INFORMATION

    MEDICAL TESTS

  • Your own observation of symptoms.
  • Medical history and physical exam by a doctor.
  • Laboratory blood counts, and blood and urine tests that measure kidney function and fluid and electrolyte balance.
  • EKG (See Glossary).
  • Needle biopsy (See Glossary) of kidneys.
  • X-rays of the abdomen, kidneys, ureters, and bladder to detect kidney stones.

    POSSIBLE COMPLICATIONS

    Congestive heart failure; increased risk of infections; chronic kidney failure.

    PROBABLE OUTCOME
    If your child's underlying condition can be controlled and the kidney failure can be treated promptly, complete recovery is likely. If not, the disorder can lead to chronic kidney failure or death.

    TREATMENT

    HOME CARE

    No specific instructions except those listed under other headings.

    MEDICATION
    Your doctor may prescribe:

  • Medications appropriate to control the underlying condition.
  • Antibiotics if infection develops.

    ACTIVITY
    Your child should rest in bed until the condition is cured. Then the child can resume normal activities as soon as symptoms improve.

    DIET & FLUIDS
    Your child's food and water intake must be rigorously controlled to prevent fluid and electrolyte imbalance, and to minimize buildup of body wastes.

    OK TO GO TO SCHOOL?

    Yes. This should not be a disabling or infectious disorder.

    CALL YOUR DOCTOR IF

  • Your child has symptoms of kidney failure.
  • The following occurs during treatment: -- Chills, fever, headache, or muscle aches. -- Shortness of breath. -- Unexpected bleeding from any body opening. ‡
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