Top 5 Causes of Acute Renal Failure

Acute Renal Failure formally called acute renal injury. Acute Renal Failure can be caused by multiple reasons. When people suffer from Acute Renal Failure, there will be lots of features in clinic. To prevent Acute Renal Failure in our daily lives, let’s start from understanding the following five common causes:

A. Shock

Various causes of shock can trigger Acute Renal Failure. The most common causes are: bleeding (hemorrhage), imbalance of water and electrolytes as well as cardiac cycle failure etc.

B. Infections

Infections of bacteria, virus and mycete can be complicated with Acute. Bacterial infection especially gram-negative infection easily incurs Acute Renal Failure. Virus infections which are prone to trigger Acute Renal Failure include viral pneumonia, cephalitis, hepatitis and epidemic hemorrhagic fever etc.

C. Extrusion

Acute Renal Failure causing by serious extrusion have an extremely complicated pathogenesis and clinical course, but also very staple in clinic.

D. Hemolysis

Incompatible blood type transfusion, old blood transfusion and mechanical hemolysis can complicate with Acute Renal Failure. The main pathogenesis is disseminated intravascular coagulation.

E. Toxins

A great quantity of toxins may trigger Acute Renal Failure, including:

1) Heavy metal compound such as mercury

2) Organic compound e.g. DDT

3) Biological poison such as snake venom

4) Renal toxic drugs, for example, antibiotics with renal toxicity.

There are several treatments toward Acute Renal Failure, such as hemodialysis, peritoneal dialysis. About 80% of pre-renal and post-renal Acute Renal Failure can recover, 40% of intrinsic Acute Renal Failure is able to recover. Accordingly, as long as you take an early treatment, certain of people with Acute Renal Failure can be treated.

Diagnosis of Acute Renal Failure (ARF)

Diagnosis of Acute Renal Failure

1. Inquire the family history and make a careful physical inspection

2. Check urine and urine output as follows:

Urine output per hour

Physical property of urine

Urine specific gravity or urine osmotic pressure

Routine Urine

3. Routine blood test

Blood routine test

Acidophilic cells increase significantly which prompts the possibilities of acute interstitial nephritis.

Blood urea nitrogen and creatinine

Creatinine and urea nitrogen rise progressively, daily blood urea nitrogen increases 3.6--7.1mmol/L while creatinine 44.2～88.4μmol/L.

Measurement of serum electrolytes, pH or plasma [HCO3]

Precautions

Notice high levels dangerous factors.

High levels dangerous factors may include severe trauma, major surgery, systemic infection, durative hypotension or renal toxicity substance.

ARF can be avoided through correcting imbalance of water, electrolytes and acid-base positively; taking anti-shock treatment properly and timely. Those measures above could help avoiding the effective hypovolemia insufficiency, relieving renal vasoconstriction.

For those who have severe crush injury in soft tissues or mistaken blood transfusion. Primary diseases should be remedied first; meanwhile, application of certain drugs can prevent obstruction of renal tubules by hemoglobin and muscle hemoglobin or damage of epithelial cells in renal tubules.

We should dilate blood volume before operation which would influence kidneys’ blood flow. Medications should be used during or after the surgery to protect renal function. Make oliguric ARF switch to non-oliguric ARF. Dopamine could dilate blood vessels which would increase the glomerular filtration rate and renal plasma flow.

When oliguria appears, we should use dehydration test, which can not only identify prerenal ARF or renal ARF, but also precaution prerenal ARF develop to renal ARF.