What is Acute Renal Failure (ARF)?

Acute Renal Failure (ARF) or Acute Kidney Injury (AKI) is marked by an abrupt decline (over hours to weeks) in the function of the kidneys. With this decline, the kidneys become unable to adequately clean the blood, control the levels of charged particles (electrolytes) in the blood, or clear excess fluid from the blood.

There are many different causes of acute renal failure. The main causes are three:

1. The kidney not getting enough blood (low blood pressure, dehydration).
2. Urine not draining from the kidneys because of blockage by stones, tumors or problems in the bladder.
3. Injury to the functional part of the kidney itself, by drugs, infections, or inflammation of the blood vessels (vasculitis).

Doctors often examine the urine, look at the kidneys with CAT scans or ultrasound and send various blood and urine tests to determine the cause of acute renal failure.

Having acute renal failure is often a sign of serious illness. It may occur in isolation, but often affects people that are very sick from other causes. This would include patients having heart or liver problems, severe infections or after a major accident. It also can happen after surgery. When the kidneys are affected as part of an illness it increases the overall likelihood of death significantly.

Risk factors for ARF include advanced age, preexisiting kidney damage (chronic kidney disease), having consumed certain drugs (ibuprofen, antibiotics) or having a significant infection.

The treatment of acute renal failure involves correcting the underlying cause.

• If the kidney is not getting enough blood, treatment includes improving blood flow by giving intravenous (IV) fluid, raising blood pressure with fluid or medications or improving the function of the heart.
• If the problem is blockage of urine flow, then removing the blockage with surgery or bypassing the blockage with a urine catheter may be necessary.
• If the kidney has been injured, stopping the drug or treating the infection that harmed the kidney is necessary.

In addition, patients with ARF may need a procedure to do the work of the kidneys like dialysis. The need is often temporary until the kidneys recover. ARF may, however, result in permanent damage to the kidneys and the need for long term dialysis or transplantation. At Boise Kidney we follow hospitalized patients at St. LukeÕs (both Boise and Meridian), St. Alphonsus and Mercy Medical Center and have available the latest technologies to treat or to try to prevent acute renal failure.