What is Acute Kidney Failure?
The kidneys help the body remove wastes from the blood. The kidneys keep the body from losing too much water, chemicals or other nutrients. Sometimes kidneys stop working well. Complete kidney failure in ICU patients is very serious and can increases the chance of dying.
What can cause acute kidney failure?
- Infection any where in the body
- Certain medicines or drugs
- Low blood pressure
- Surgery
- Dehydration
- serious illness
- Blockage of the bladder pipe (urethra) or kidney tubes (ureter) by kidney stones or tumors
What are common symptoms?
Patients in the ICU often have no symptoms, but can have:
- Low urine output or not urinating at all
- Nausea or vomiting
- Tiredness
- Swelling, especially in the feet, ankles, and legs
- Confusion
- Shortness of breath
- Not wanting to eat
- Itchiness
How is kidney failure found?
- Blood tests
- Urine tests
- Sometimes an Ultrasound or CT scan are needed to help find the cause of the problem
How is it treated?
- By treating the cause of kidney failure; like giving antibiotics for infection
- Give extra fluids through IVs in the veins
- Give nutrients, like calcium or potassium
- Limiting salt
- Medicines can also be used to remove potassium from the blood if the level gets too high
- High potassium can cause heart problems
- Sometimes people need dialysis if the kidneys are in complete failure. This treatment may not be used for all patients.
- When dialysis is used, a catheter (large needle with tubing) is placed in a vein. Often, this is put in the neck. Blood will pass inside the tubing from the body to the machine. The machine does the kidneys’ job. Cleanes blood then goes back into the veins and returns to the body. The blood loss is very small.
In the ICU there are two types of dialysis that are used to clean the blood.
- Daily dialysis (or “intermittent”): Patients with stable blood pressure are connected to a dialysis machine for a few hours every day.
- Continuous dialysis (Called CVVH): Patients with low blood pressure are treated; this is on-going 24 hours a day
What should I expect to happen?
Kidney failure can improve over a days to weeks. In some patients it never gets better. Dialysis may then be required for the rest of the patient’s life or the doctor may suggest stopping dialysis.