The word "renal" refers to the kidneys. When a patient is in acute renal failure, he has kidney failure. The function of the kidney is to filter and remove waste products from the body. If the kidneys fail, there is a buildup of waste products, which will affect other major organs within the body and cause complications.
History
Acute renal failure occurs when there is a sudden loss of kidney function. Kidney failure can be caused from blood loss, severe dehydration or a systemic infection within the body. An obstruction such as a tumor may also impair the flow of urine from the kidneys to the bladder, which can cause acute renal failure.
Symptoms
According to the Mayo Clinic, a patient with acute renal failure will have decreased urine output, swelling of legs, ankles or feet and drowsiness. Because of the systemic effects kidney failure can have, the patient may experience shortness of breath, chest pressure or seizures. Symptoms will vary from patient to patient. In some cases, the patient will have no symptoms, and the disorder is only discovered by a laboratory test.
Complications
Complications of kidney failure can effect multiple systems of the body. When the kidneys are effected, less urine output occurs which will lead to fluid retention. Fluid retention causes the swelling of hands, feet and legs. As fluid backs up, it can effect the cardiovascular system, causing the patient to have high blood pressure and possibly heart failure because the heart cannot pump the additional fluid. As fluid overload continues, the respiratory system is affected, and the patient will develop shortness of breath. Waste products will build up in the blood and can effect the patient's mental status. Confusion, decreasing level of alertness and seizures are complications associated with the build-up of toxins in the blood stream. Acute kidney failure will impact red blood cell production, which means there is a decreased in the amount of red blood cells that carry oxygen to the tissues. Kidney failure causes nausea, vomiting and anorexia. When a patient is not getting the necessary nutrition, she will lose body mass and muscle.
Treatment
The primary treatment for acute renal failure is to eliminate the cause and support the patient's kidney function by reestablishing blood flow to the kidneys. Patients fluid and electrolytes will be monitored closely. Fluid balance is critical, so patients will have all fluid intake and output measured. Daily weights are critical for patients with kidney failure. Specific laboratory tests of creatinine and blood urea nitrate are completed. These studies help identify worsening or improvement in kidney function. Adequate nutritional support is necessary to help combat malnutrition, and sodium is restricted to prevent any additional fluid retention.
Outcome
In most cases of acute renal failure, once the underlying cause is treated, normal kidney function returns within weeks.
References
- "Essentials of Critical Care Nursing"; McGraw Hill; 2006
- "Nursing 2003"; How acute renal failure puts the brakes on kidney function; Campbell; January 2003
