Acute kidney failure : types, symptoms and treatment options

Acute kidney failure (AKF) A kidney disease in which our kidney suddenly lose their tendency to excrete salt, water, and waste materials from the blood.

How we detect Acute kidney failure

If a person has acute kidney failure then the doctor suggests the following test which is given below:

  1. Urine output measurement
  2. Urine tests
  3. Blood tests
  4. Imaging tests
  5. Sample of kidney tissue removal for testing

Urine output measurement

In this case doctor measure how much you urinate in 24 hours.

Urine test:

In this case a sample of urine is analyzed.

Blood test:

In this case a sample of blood is taken which describe urea and creatinine high level.

Imaging test:

In this case doctor use different imaging test such as ultrasound and tomography to detect.

Sample of kidney tissue removal for testing:

In this case a doctor suggest kidney biopsy for sample of kidney removal for lab testing.

Feature of Acute failure of the kidney

Acute failure of kidney symptoms

  • urine output is decreased but in some cases output of urine remain constant
  • Swelling in legs ankle and feet occur due to retention of fluid
  • breathless
  • tiredness
  • unsureness
  • retching
  • deficiency
  • Arrhythmia
  • Coronary infraction

The disease which cause kidney diseases

  • Blood clots in kidney veins and arteries cause kidney disease
  • Cholesterol deposit that block blood flow in kidney cause kidney disease
  • Glomerulonephritis (inflammation of tiny tubules of kidney) cause kidney disease
  • Syndrome of hemolytic uremic (syndrome occur due to red blood cells premature destruction) cause kidney disease
  • Lupus ( disorder of immune system that become a reason of  glomerulonephritis ) cause kidney disease
  • During imaging test usage of medicine and chemotherapy drug cause kidney disease
  • Scleroderma ( rare diseases group that belongings to the skin and connective tissue ) cause disease
  • Alcohol ,heavy metals toxin and cocaine can cause kidney disease
  • Muscle tissue breakdown can cause kidney disease
  • Breakdown of tumor cells also cause kidney disease

Phases of acute failure of kidney /acute injury of the kidney

Acute injury of  kidney have four different phases which are given below

  1. Onset phase
  2. Oliguria phase
  3. Diuretic phase
  4. Recovery phase

Onset phase:

   In this phase injury of kidney occur.

Oliguria phase:

urine output concentration is  decreased during this phase due to renal tubules damages.

Diuretic phase:

kidney try to heal during this phase but output of urine increases and tubular damage occur.

Recovery phase:

Renal function improve during this phase.

Types of acute failure of  kidney /acute injury of  kidney:

  1. Prerenal acute injury of the kidney
  2. Intrinsic acute injury of the kidney
  3. Post renal acute injury of the kidney

Who gets an acute failure of kidney

Anyone can get acute injury of kidney followings things that increases the chances of acute kidney diseases are given below

  • Having age of 65 and more
  • Having a renal diseases
  • Having hypertension
  • Having a long term diseases such as cardiac diseases , liver diseases and diabetes
  • Having a peripheral artery diseases

Treatments available for acute kidney failures

There are following treatment for acute kidney failures such as

  • Dialysis
  • Kidney transplant
  • Conservative managements

Dialysis

Dialysis is the treatment for removal of extra aqua, solutes and poisons from the blood of  people whose kidney are not performed the normal function properly.

Dialysis history:

1940 the kidney dialysis history was obtained. In 1943 by Dutch Physician Willemskolff first build the concept of artificial kidney. when he first saw the patient suffering from kidney failure he achieved the idea of developing the machine to clan the blood of the patient. He treat dozen of patient having acute failure of kidney .in late 1940 kolff came to united states and at mount Sinai hospital he work to find the best kidney treatment to make the patients healthy.hospital oppose the kolff idea so he and his colleagues do experiment at separate place in early 1950 to improve this idea many experiments were performed.

However kolff apparatus was applicable for acute failure of kidney nor for chronic failure of kidney. at the university of Washington a professor of medicine  Dr.Bieldingscribner developed a treatment for chronic failure of kidney.the first official medical clinic was first build by scribner in in 1962.

The patient may received treatment at home by utilizing the machine developed by scribner. 40 percent patient utilized this treatment at home in 1973.Now a day at dialyzer center 90 percent of the patient receive this treatment. Availability of many dialysis treatment are occur such as peritoneal dialysis and nocturnal dialysis.

Types:

Two classification  of dialysis are present which are given below peritoneal form of dialysis hemodialysis

Principle of dialysis:

Across semi- permeable membrane the diffusion of particles and ultrafiltration of of fluid principle was utilized by dialysis

Hemodialysis

A medical procedure to remove extra fluid and waste and to correct electrolytes imbalance. It is normal kidney function replacement blood is passed through a filter outside the body and filter blood is return back to body during hemodialysis.

For removal of harmful waste and extra fluid your blood is filtered .it assist  to controls blood pressure. important minerals like potassium , sodium and calcium in body are balanced by hemodialysis  .patient feel better due to hemodialysis and it is long lasting

Three times a weak in dialyzer center hemodialysis was performed  and each session has duration of four hours .Hemodialysis is also done at home .Hemodialysis is used to treat both acute (temporary) and chronic(permanent) kidney hemodialysis.

Advantages of hemodialysis

  • It is carried out in the comfort of patient home
  • Effective removal of waste products
  • It is given by trained professionals
  • Rapid correction of electrolyte imbalance
  • Treatment usually occur three times a day

Disadvantages of hemolysis

  • Require specialized staff and equipment
  • Protein lose
  • Require systematic heparinization

Types of hemodialysis

There are three types of hemodialysis which are given below

  1. Conventional hemodialysis
  2. Daily hemodialysis
  3. Nocturnal hemodialysis

Conventional hemodialysis

It take place typically in center three times in week and each session has duration of four hours it involves Medical personal and during treatment patient play a passive role.

Daily hemodialysis

It is conducted in dialysis output facility, either a purpose build room in a hospital or dedicated ,standalone clinic.

Nocturnal hemodialysis:

A t home In the absence of medical personal typically at night or when patient is sleep it is performed and during treatment patient play a role of performer

Flexible schedule of hemodialysis

  • Standard home schedule of hemodialysis
  • The short daily schedule of hemodialysis
  • Nightly home schedule of hemodialysis

Peritoneal form of dialysis

Peritoneal form of dialysis is the treatment for acute failure of kidney in which abdomen or belly is lined to filter blood inside body. Lining is called peritoneum.

Changes occur before peritoneal dialysis:

A few week before peritoneal dialysis is start a surgeon place in abdomen a soft tube called catheter

Procedure of peritoneal dialysis:

Solution of dialysis which contain water with some addidives is run from a container by the catheter into abdomen. This bag is detached when the bag containing dialysis fluid was empty and you put a cap on catheter the process of put a cap on catheter is necessary for the normal activities of patient.extra fluid was observed by dialysis solution in your belly.

when solution is placed for few hours in belly then wastes are moved out of the body and the vacant bag are  removed  and  the used solution are also wastes in to toilet or tub. When the solution is fresh it absorb waste quickly as time pass it efficiency is low.due to this reason this process is repeated again and again.

Types of peritoneal form of dialysis:

peritoneal form of dialysis have two classification  which are that (1)Continuous form of ambulatory peritoneal dialysis (2)Automated form of peritoneal dialysis

Continuous form of ambulatory peritoneal dialysis:

3 to 5 time each day in any environment this treatment is occur without a machine. it is called ambulatory because it is occur at home at work or while travelling .2quartz of cleansing fluid was placed inside abdomen and later this fluid was drain a plastic bag of the fluid called dialysate is connected to the soft tube in abdomen called peritoneal dialysis catheter  by raising the plastic bag to shoulder level.

when plastic bag is raising then gravitational pull moves the fluid into abdomen this process is called filling .plastic bag is removed when it is removed and plastic bad is waste away. Inside abdomen cleansing fluid is remain for few hours  this process is called dwelling.

waste products and extra fluid move out of blood during this process through the peritoneal membrane into dialysate .When this process is complete then dialysate is removed from the abdomen through the catheter into a plastic bag .and it can be secured and thrown away.

This process  is called draining. These three processes like filling dwelling and draining is  collectively called an exchange .The actual time taken by draining and filling is about 30 minutes.it is done during regular daily activities.

Automated peritoneal dialysis:

It is automated process that used a machine called cycler.it is occur in different time or at different places or while sleep.

Kidney transplant

A treatment in which a kidney is transplanted

Procedure of kidney transplant:

General anesthesia is required for a kidney transplants so the patient not awake during this procedure. Heartbeat, hypertension, and blood sugar level throughout the procedure are monitored by the surgical team who monitor a process incision is make in the lower part of the abdomen by the surgeon during this surgery and place the kidney into body then the question is raised why this procedure occurs?

the answer of this question is that this treatment is necessary when patient own kidney are causing complication like hypertension, kidney, stone pain or infection. The recently developed kidney blood vessels are combined to the blood vessels present in the below part of the patient’s belly. The new kidney bladder( a tube that connects the kidney to the bladder) is connected to the patient’s bladder.

How can a person live with a kidney transplant:

The expecting life expectancy of a  patient undergoing dialysis is generally five years. Secondly, a patient who takes renal transplantation can live more year than the patient receives dialysis. On average a living donor renal functions twelve to twenty years while an expired donor renal may work for eight to twelve years.

 

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