| Definition: | Acute renal failure is sudden loss of the ability of the kidneys to excrete wastes, concentrate urine, and conserve electrolytes. ("Acute" means sudden, "renal" refers to the kidneys.)
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| Alternative Names: | Renal failure - acute; Kidney failure; Kidney failure - acute; Renal failure; ARF
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| Causes, incidence, and risk factors: | The kidneys filter wastes and excrete fluid by using the bloodstream's own natural pressure. There are numerous potential causes of damage to the kidneys.
- Decreased blood flow -- this may occur when there is extremely low blood pressure caused by trauma, complicated surgery, septic shock, hemorrhage, or burns; associated dehydration; or other severe or complicated illnesses.
- Acute tubular necrosis (ATN) -- may occur when tissues aren't getting enough oxygen or when the renal artery is blocked or narrowed (see acute arterial occlusion of the kidney and renal artery stenosis).
- Over-exposure to metals, solvents, radiographic contrast materials, certain antibiotics, and other medications or substances.
- Myoglobinuria (myoglobin in the urine) -- this condition may be caused by rhabdomyolysis, alcohol abuse, a crush injury, tissue death of muscles from any cause, seizures, and other disorders.
- Direct injury to the kidney.
- Infections such as acute pyelonephritis or septicemia.
- Urinary tract obstruction, such as a narrowing of the urinary tract (stricture), tumors, kidney stones, nephrocalcinosis or enlarged prostate with subsequent acute bilateral obstructive uropathy.
- Severe acute nephritic syndrome.
- Disorders of the blood, such as idiopathic thrombocytopenic purpura (ITP), transfusion reaction, or other hemolytic disorders, malignant hypertension and disorders resulting from childbirth, such as bleedingplacenta abruptio or placenta previa can damage the kidneys.
- Autoimmune disorders such as scleroderma can cause also acute renal failure.
- In young children, hemolytic uremic syndrome is an increasingly common cause of acute renal failure. A toxin-secreting bacterium, Escherichia coli, found in contaminated undercooked meats, has been implicated as the cause of hemolytic uremic syndrome.
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