It contains the brief information on acute renal failure otherwise called as acute kidney injury...

1. Dayaratnam Madugula
III B Pharmacy
SIMS College of Pharmacy, Guntur.
ACUTE RENAL FAILURE

2. What is acute kidney failure?
Acute kidney failure happens when your kidneys suddenly lose the ability to
eliminate excess salts, fluids, and waste materials from the blood. This
elimination is the core of your kidneys’ main function. Body fluids can rise to
dangerous levels when kidneys lose their filtering ability. The condition will also
cause electrolytes and waste material to accumulate in your body, which can also
be life-threatening.
Acute kidney failure is also called acute kidney injury or acute renal failure. It may
develop rapidly over a few hours. It can also develop over a few days to weeks.
People who are critically ill and need intensive care have the highest risk of
developing acute kidney failure.
Acute kidney failure can be life-threatening and requires intensive treatment.
However, it may be reversible.

3. Symptoms
Signs and symptoms of acute kidney failure may include:
•Decreased urine output, although occasionally urine output
remains normal
•Fluid retention, causing swelling in your legs, ankles or feet
•Drowsiness
•Shortness of breath
•Fatigue
•Confusion
•Seizures or coma in severe cases
•Chest pain or pressure
Sometimes acute kidney failure causes no signs or symptoms
and is detected through lab tests done for another reason.

4. Classification
The causes of acute kidney injury are commonly categorized
into prerenal, intrinsic, and postrenal.
Pre-renal:-
Prerenal causes of AKI ("pre-renal azotemia") are those that
decrease effective blood flow to the kidney and cause a decrease in the
glomerular filtration rate (GFR). Notable causes of prerenal AKI include
low blood volume (e.g., dehydration), low blood pressure, heart failure
(leading to cardio renal syndrome), liver cirrhosis and local changes to
the blood vessels supplying the kidney. The latter include renal artery
stenosis, or the narrowing of the renal artery which supplies the kidney
with blood, and renal vein thrombosis, which is the formation of a blood
clot in the renal vein that drains blood from the kidney.

5. Intrinsic:-
Intrinsic AKI refers to disease processes which directly damage the
kidney itself. Intrinsic AKI can be due to one or more of the kidney's
structures including the glomeruli, kidney tubules, or the interstitium.
Common causes of each are glomerulonephritis, acute tubular necrosis
(ATN), and acute interstitial nephritis (AIN), respectively. Other causes of
intrinsic AKI are rhabdomyolysis and tumor lysis syndrome. Certain
medication classes such as calcineurin inhibitors (e.g., tacrolimus) can also
directly damage the tubular cells of the kidney and result in a form of
intrinsic AKI.
Post-renal:-
Postrenal AKI refers to acute kidney injury caused by disease states
downstream of the kidney and most often occurs as a consequence of
urinary tract obstruction. This may be related to benign prostatic
hyperplasia, kidney stones, obstructed urinary catheter, bladder stones, or
cancer of the bladder, ureters, or prostate.

7. Diagnosis
If your signs and symptoms suggest that you have acute kidney
failure, your doctor may recommend certain tests and procedures to
verify your diagnosis. These may include:
•Urine output measurements. The amount of urine you excrete in a day
may help your doctor determine the cause of your kidney failure.
•Urine tests. Analyzing a sample of your urine, a procedure called
urinalysis, may reveal abnormalities that suggest kidney failure.
•Blood tests. A sample of your blood may reveal rapidly rising levels of
urea and creatinine — two substances used to measure kidney function.
•Imaging tests. Imaging tests such as ultrasound and computerized
tomography may be used to help your doctor see your kidneys.
•Removing a sample of kidney tissue for testing. In some situations, your
doctor may recommend a kidney biopsy to remove a small sample of
kidney tissue for lab testing. Your doctor inserts a needle through your
skin and into your kidney to remove the sample.

8. Treating complications until your kidneys recover:
 Treatments to balance the amount of fluids in your blood.
 Medications to control blood potassium.
Treatment:-
Treatment for acute kidney failure typically requires a hospital stay.
Most people with acute kidney failure are already hospitalized. How long
you'll stay in the hospital depends on the reason for your acute kidney
failure and how quickly your kidneys recover.
 Medications to restore blood calcium levels.
 Dialysis to remove toxins from your blood.