Acute kidney failure is different from chronic kidney failure. Unlike patients with chronic kidney disease, patients with acute disease do not have the luxury of years of experience and mental preparation for the eventuality of kidney failure. Because renal medicine is a particularly complicated and distinctive specialty, even people in the medical profession may lack the knowledge to ground their experience. Because acute kidney failure is often a side effect of some other disease, patients often feel like their bodies are falling apart.
Causes
Acute kidney failure can be caused by a number of external or internal factors. External factors include drugs such as ibuprofen, cyclosporine, cancer chemotherapy drugs or angiotensin-converting enzyme inhibitors, such as lisinopril and other ACE inhibitors.
Internal factors include cardiac disease, circulatory defects and sepsis. Merck notes that acute failure can also be caused by obstructions in the urethra and bladder. Patients with chronic kidney disease are also more vulnerable to acute failure.
History
The modern history of acute kidney failure treatments begins in the early 1940s when Dr. Willem Kolff perfected the first dialysis machine. DaVita.com recounts how truly revolutionary this treatment was. When it was first introduced in the U.S. by a Dutch physician, many people in the medical field called dialysis machines "an abomination."
After World War II, Kolff donated the five machines he constructed to various medical facilities throughout the world, including one in the U.S. at Mt. Sinai Hospital in New York City. Because these machines were so rare and so untested, their use was limited to patients with acute kidney failure.
Treatment
Dialysis is the primary means of treating acute kidney failure. Patients are hooked up to a hemodialysis machine, often via a catheter placed in a major blood vessel in the neck or elsewhere. The dialysis machine performs the filtration function of the kidneys and removes waste products from the blood.
The American Academy of Family explains that monitoring vital signs and urine output is essential. Physicians look to these functions so they can prescribe the medications necessary to help with other kidney functions that may be compromised, such as blood pressure regulation.
The AAFP urges physicians to identify and treat the underlying cause of the acute renal failure.
Misconceptions
The AAFP notes that patients with acute kidney failure were traditionally treated with dopamine. It was thought that dopamine would help "jumpstart" the kidney. This practice is unnecessary as a meta-review of of 58 different studies on the use of dopamine in critically ill patients shows that administration of dopamine did not prevent morbidity or mortality.
Innovations
Some of the most promising research for treatment of kidney disease involves new approaches to acute disease. A 2006 article in MIT's "Technology Review" discussed the work of David Hume, who developed a device that performs the filtration functions of traditional dialysis with all the other metabolic functions of real kidneys. This device uses both stem cell tissue and a mechanical component. Clinical trial results look promising as the survival rate of acutely ill patients improved 70 percent after 28 days of treatment.
