Kidney Failure (cont.)
Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- Kidney failure facts
- What are the kidneys?
- What causes kidney failure?
- What are the symptoms of kidney failure?
- How is kidney failure diagnosed?
- What is the treatment for kidney failure?
- Peritoneal dialysis
- Kidney transplantation
- What is the prognosis for someone with kidney failure?
- Find a local Nephrologist in your town
What causes kidney failure?
Kidney failure can occur from an acute situation or from chronic problems.
In acute renal failure, kidney function is lost rapidly and can occur from a variety of insults to the body. The list of causes is often categorized based on where the injury has occurred.
Prerenal causes (pre=before + renal=kidney) causes are due to decreased blood supply to the kidney. Examples of prerenal causes of kidney failure are:
- hypovolemia (low blood volume) due to blood loss;
- dehydration from loss of body fluid (for
example, vomiting, diarrhea, sweating, fever);
- poor intake of fluids;
- medication, for example, diuretics ("water pills") may cause excessive
water loss; and
- abnormal blood flow to and from the kidney due to obstruction of the renal artery or vein.
Renal causes of kidney failure (damage directly to the kidney itself) include:
- Sepsis: The body's immune system is overwhelmed from infection and
causes inflammation and shutdown of the kidneys. This usually does not occur
with urinary tract infections.
- Medications: Some medications are toxic to the kidney, including
anti-inflammatory drugs like ibuprofen and
potentially toxic medications include
antibiotics like aminoglycosides [gentamicin
(Garamycin), tobramycin], lithium
(Eskalith, Lithobid), iodine-containing medications
such as those injected for radiology dye studies.
- Rhabdomyolysis: This is a situation in which there is significant muscle
breakdown in the body, and the damaged muscle fibers clog the
filtering system of the kidneys. this can occur because of trauma, crush
injuries, and burns. Some medications used to treat high
cholesterol can cause
- Multiple myeloma
- Acute glomerulonephritis or inflammation of the glomeruli, the filtering system of the kidneys. Many diseases can cause this inflammation including systemic lupus erythematosus, Wegener's granulomatosis, and Goodpasture syndrome.
Learn more about: Eskalith
Post renal causes of kidney failure (post=after + renal= kidney) are due to factors that affect outflow of the urine:
- Obstruction of the bladder or the ureters can cause back pressure because the kidneys continue to produce urine, but the obstruction acts like a dam, and urine backs up into the kidneys. When the pressure increases high enough, the kidneys are damaged and shut down.
- Prostatic hypertrophy or prostate cancer may block the urethra and prevents
the bladder from emptying.
- Tumors in the abdomen that surround and obstruct the ureters.
- Kidney stones. Usually, kidney stones affect only one kidney and do not cause kidney failure. However, if there is only one kidney present, a kidney stone may cause the lone kidney to fail.
Chronic renal failure develops over months and years. The most common causes of chronic renal failure are related to:
Less common causes of chronic renal failure include:
- polycystic kidney disease,
- reflux nephropathy,
- kidney stones, and
- prostate disease.
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