Acute renal insufficiency (or kidney failure) is a loss of kidney functions. A kidney can suddenly stop working for a whole variety of reasons. However, in general, we can talk about the three major causes of renal insufficiency. First, a disease such as glomerulonephritis may suddenly damage the kidneys to such an extent that it causes the insufficiency. Second, a sudden drop in blood pressure, which is possible after severe bleeding or severe heart failure, can reduce the blood supply (blood flow) to the kidneys that are particularly susceptible to such conditions. Third, a sudden and complete blockage of the urinary tract, bladder or urethra may occur. Due to any of these conditions, the waste material and water accumulate in the body, since they can no longer be efficiently excreted, leading to the disturbance in the balance of chemical compounds controlled by the kidneys.
The most obvious symptom is the abnormally low amount of urine, i.e. less than half a liter per day. Soon afterwards, the patient loses the appetite, feels a strong sickness and starts to vomit. Symptoms such as cramps and even coma may occur if the treatment is delayed. However, in most cases, the symptoms of the disease that caused acute renal insufficiency occur before the symptoms of the insufficiency itself.
Mild attacks of acute renal insufficiency are relatively common, while the heavier forms of this disease (e.g. glomerulonephritis) are extremely rare.
Although dangers depend on the severity of the underlying disease, acute renal insufficiency is a potentially dangerous condition and, in some cases, lifelong treatment with dialysis devices will be required.
What to do?
The patient is urgently required to undergo hospital treatment with a variety of intensive diagnostic tests, such as blood and urine tests, intravenous piedography (IVP), and possibly kidney biopsy.
If acute insufficiency is a result of severe bleeding or heart attack, an emergency medical intervention is usually needed, and its shape depends on the circumstances. If diagnostic tests show that the cause is a blockage in the urinary tract, the patient will probably be operated to remove the cause of the blockage. However, if the cause of the insufficiency is the kidney disease itself – or, most often, if the kidneys are in serious condition, and even after the successful treatment of the underlying cause of insufficiency – treatment becomes much more complicated.
Sometimes, intravenous infusion of blood or plasma is sufficient for restoring kidney functions, probably with the addition of diuretics (an urinary excretory drug). However, doctors may need to apply a special device to perform kidney functions as long as they are recovering. This treatment is called dialysis, and it is painless. Patients with acute renal insufficiency must sometimes stay in the hospital for six weeks, and longer, until the kidneys begin to function again.
During the treatment, a special diet will be required – large number of calories, little protein and up to 600 ml of fluid per day. With this type of diet, the work of a kidney (or device) is minimized. The body gets enough energy – glucose in the form of jam or honey – with a small amount of waste, as foods that are rich in proteins (e.g. meat and eggs) are avoided. As the kidneys gradually recover, the patient is gradually disconnected from the dialysis device and can begin with a normal nutrition.