Acute renal failure (ARF) is a pathological condition in which renal failure occurs. The disease is very dangerous in that there are many reasons for its development, and the symptoms appear unexpectedly, which requires urgent medical attention. What factors contribute to the development of pathology and what is the treatment of acute renal failure, we will analyze in the article.
What is an arrester
In simple words, acute renal failure is an unexpected loss of the kidney’s ability to remove toxic substances, excess fluid, and potassium from the body. In this regard, there is a disorder of the water-salt and electrolyte balance, the general metabolism is disturbed. All this has a negative impact on the work of all body systems.
ARF develops suddenly. As a rule, this happens in a few hours or days and requires immediate medical attention.
Basically, with timely treatment of acute renal failure, organ functions can be fully restored. Lethal outcomes due to this disease are rare and occur in advanced stages in the absence of therapeutic therapy. The disease in most cases affects the elderly.
Stages of the disease
Developing, acute renal failure passes through several stages.
- The first stage is characterized by minor changes in the functioning of the kidneys. The amount of urine released is slightly reduced. This stage passes unnoticed, since there are practically no obvious signs of the disease.
- In the second stage, the work of the kidneys deteriorates, the volume of urine is significantly reduced. A blood test may show an increased creatinine value. And due to the fact that fluid accumulates in the body, the patient has swelling and disturbances in the cardiovascular system.
- In the third stage, nephrons begin to die, and the blood plasma fills the urinary ducts. A person develops tachycardia, dry skin, signs of intoxication are expressed. There are times when a person at this stage falls into a coma.
- The next stage - occurs only with effective therapy. Urine volume increases, in nephrons, filtration is restored.
Causes
Since there are a lot of reasons for the occurrence of acute renal failure, it is customary to separate them into several groups, depending on the provoking factors.
Prerenal (nonrenal). Up to 80% of all cases of the development of the disease. They arise due to impaired blood supply to the kidneys and a decrease in the filtration rate. Provoking factors can be:
- renal hypoperfusion;
- bleeding
- large fluid loss, for example, with severe vomiting or diarrhea;
- burns;
- hemolysis;
- liver failure;
- pathology of the heart;
- infections.
Renal. Up to 40% of cases of acute renal failure. The causes will be lesions in the kidneys themselves, which can occur as a result of inflammatory processes, the action of toxins and drugs, or with the pathology of blood vessels in the organ. Factors for the occurrence of the disease are:
- intoxication with medicines, toxic substances, animal bites, heavy metals, alcohol;
- pyelonephritis;
- glomerulonephritis;
- thrombosis;
- atherosclerosis;
- aneurysm;
- kidney injury.
Postrenal. They arise due to pathologies that violate the normal outflow of urine. But kidney function is preserved. Up to 10% of all cases. Urinary obstruction occurs for the following reasons:
- urolithiasis disease;
- ureteral injury;
- tumor processes;
- inflammatory processes;
- hematomas;
- spasms of the sphincter of the bladder;
- prostatic hyperplasia.
Risk factors
As a rule, acute renal failure can occur due to diseases such as:
- diabetes;
- pathology of the kidneys and liver;
- cardiovascular diseases;
- hypertension;
- elderly age;
- pathology of peripheral vessels.
Symptoms
Symptoms in acute renal failure will depend on its stage and the provoking disease.
- First, a person feels a general malaise, loss of appetite, drowsiness, and symptoms of poisoning.
- Further, the amount of urine decreases and its color changes, becoming darker.
- Hallucinations, convulsions, nausea, and vomiting may occur.
- The skin turns pale, bruising is possible.
- The patient is very swollen.
- There are signs of tachycardia.
- Violation of the stool.
- Bloating.
- Sleep disturbances.
- Pallor of the skin.
Bad breath and a rash are also likely.
Diagnostics
In order to find out the exact diagnosis and degree of kidney damage, it is necessary to carry out a number of diagnostic measures, which will be designated by a therapist or a doctor of a narrow specialty - a nephrologist.
First of all, the medical history is collected, hereditary factors and the presence of chronic diseases are specified. Further, the following procedures can be assigned:
- biochemical and general blood tests, in which special attention is paid to the level of red blood cells, hemoglobin, the presence of urea and creatine;
- analysis of urine, including its specific daily weight and bacteriological studies;
- immunological studies;
- blood pressure determination;
- ECG;
- ultrasound examination of the kidneys;
- MRI or CT;
- endoscopic examinations;
- taking a sample of kidney tissue for biopsy.
Pathology treatment
Since this disease develops suddenly and progresses rapidly, treatment of acute renal failure should be carried out only in a hospital setting. The duration of therapy depends on the degree of development of the disease, the condition of the patient and the response of his body to ongoing medical manipulations. The main principle of the treatment of acute renal failure is the identification and elimination of the causes of the pathology.
You should know how to behave with a patient before the arrival of an ambulance. Necessarily necessary:
- try to calm a person;
- put it on a flat surface, raising a little leg;
- provide a stream of fresh air and get rid of excess clothing.
When diagnosing an acute renal failure clinic, treatment is prescribed individually. The effectiveness of therapy depends on how quickly the causes of this condition were identified.
The treatment of acute renal failure in stages is the most effective. For example, when diagnosing the initial stage of the development of the disease, the main goal will be to eliminate the cause of its appearance. In the second and third stages, it is necessary to restore kidney function and eliminate all complications.
Let us consider in more detail the therapeutic methods used in the treatment of acute renal failure.
- First you need to eliminate the causes of the pathology: stop taking medications that could provoke the development of the disease, remove toxins, poisons, and more.
- Then, drugs that restore the water-electrolyte balance are prescribed. If the pathology was provoked by a sharp loss of fluid (for example, with bleeding), intravenous administration of special solutions is used. If fluid retention occurs in the body, diuretics are prescribed.
- If the test results showed increased potassium values, calcium preparations are used.
- For heart rhythm disturbances, drugs are recommended that can normalize it.
- If the cause of the development of the disease is infectious processes, the clinical standards for the treatment of acute renal failure suggest the use of antibiotics recommended by a doctor.
- When diagnosing anemia, iron-containing drugs are prescribed.
- If symptoms of intoxication are observed, gastric lavage procedures or administration of sorbents may be performed.
- If a large number of toxic products are detected in the blood, the patient undergoes a hemodialysis procedure. A special apparatus mechanically pumps the patient's blood through special filters that prevent the back penetration of unnecessary substances - toxins, excess potassium and others.
- In some cases, surgery may be used. This method is advisable in the presence of mechanical obstruction of the outflow of urine.
In almost all cases, ARF is treated in intensive care.
After the acute symptoms of the disease have been removed, medications that improve microcirculation in the kidneys may be prescribed.
Diet
Proper nutrition with the above therapy plays an important role. During the treatment of acute renal failure, doctors' recommendations will necessarily include adherence to a special diet. It completely eliminates the use of foods that can burden the kidneys.
Despite the fact that nutritional characteristics are selected individually, the principles of the treatment of acute renal failure with a diet will be the same for all patients with this diagnosis.
- Limit potassium-rich foods. For example, bananas, potatoes, tomatoes. The use of apples, carrots, strawberries is recommended.
- Limit salt intake.
- Protein-free diet (prescribed in most cases).
Acute renal failure in children
The causes of the development of the disease in childhood will be the same as in adults. But congenital anomalies are also possible. They can be hereditary or occur due to fetal hypoxia and intrauterine developmental disorders. Such conditions are rarely diagnosed, but can lead to irreparable consequences.
Treatment of acute renal failure in children will be aimed at eliminating the cause of the disease and restoring the functionality of the organ.
A newborn baby who has symptoms of the disease must be placed in the incubator, in which the temperature regime will be observed. Every 2-3 hours, the child changes the position of the body and makes a light massage.
Possible complications
Without appropriate treatment, the patient may experience serious complications that threaten to become irreversible. Since the kidneys play a very important role in the body, the pathological processes taking place in them disrupt the functioning of the whole organism. People with acute renal failure with a complete loss of organ functionality throughout their lives will depend on hemodialysis. Another way to restore the body will be a complete transplant.
But the worst outcome of the disease is death.
Prevention
In order to prevent the development of acute renal failure, a number of preventive measures are necessary.
These include the following.
- Maintaining normal water balance.
- Avoidance of taking nephrotoxic drugs.
- All medications should be used only when prescribed by your doctor. This is especially true for people predisposed to acute renal failure (heredity, a history of kidney disease).
- Therapy for kidney and urinary tract diseases should be determined by the attending physician. It is necessary to completely cure the pathology, preventing the disease from developing into a chronic form.
- Exclusion of contact with toxic substances / poisons.
- Treatment of chronic diseases, especially those that can affect the functioning of the kidneys.
- Timely passage of professional examinations.
- During pregnancy, follow all the recommendations of the attending physician and undergo screening studies in time. During the bearing of a child, it is necessary to eat properly, abandon bad habits and not take medicines that are prohibited in this condition.
Doctors Forecast
Forecasts of doctors directly depend on the time of contacting a medical institution. In about half of the patients who went to the doctor on time, kidney function is fully restored. In some patients, for certain reasons (for example, due to age, intolerance to certain drugs), organ functions are partially restored.
If untreated, acute renal failure can progress to the chronic stage, which is fraught with the development of serious complications that cannot be treated. For this reason, pathologies of other organs and systems that can lead to death may develop.
Conclusion
Acute renal failure is a highly fatal disease. It is worth remembering that with timely access to a doctor, the risk of serious complications is minimized. Any pain in the region of the kidneys and lower back, pain during urination is an occasion to visit the hospital as soon as possible and pass the necessary tests.