Acute kidney failure (AKF), also known as acute renal failure (ARF) and acute kidney injury (AKI), may occur with or without chronic kidney disease (CKD). AKF typically develops quickly, within a few days, and commonly occurs in individuals who are critically ill. Many are hospitalized and/or in the intensive care unit (ICU). As a potentially severe condition, it is important to understand acute kidney failure, including its symptoms, causes, risk factors, complications, and ways to prevent it.* 

What is acute kidney failure? 

Acute kidney failure happens when your kidneys suddenly are unable to filter waste products from your blood. Without this, dangerous levels of waste may build up, and your body’s chemical makeup may get out of balance. While this condition can be fatal, it also can be reversible—especially if you are in otherwise good health. 

What are the symptoms of AKF?

Symptoms range from mild to severe and may include: 

• Decreased urine output, although sometimes output remains normal
• Fluid retention, commonly seen in legs, ankles, and feet
• Shortness of breath
• Fatigue
• Confusion
• Nausea
• Weakness
• Irregular heartbeat
• Chest pain or pressure
• Seizures or coma in severe cases

What causes acute kidney failure?

AKF may be caused by these three main issues: impaired blood flow to the kidneys, damage to the kidneys, or urine blockage in the kidneys.

Impaired blood flow to the kidneys

This can be associated with:

• Blood pressure medications
• Heart attack
• Heart disease
• Infection
• Liver failure
• Use of aspirin, ibuprofen, naproxen sodium, or other similar drugs
• Severe allergic reaction (anaphylaxis)
• Severe burns
• Severe dehydration 

Damage to the kidneys

This may be related to:

• Blood clots to the veins and arteries in and around the kidneys
• Cholesterol deposits that block blood flow to the kidneys
• Infection
• Medications, such as certain chemotherapy drugs, antibiotics, and dyes used during imaging tests
• Toxins, like heavy metals, alcohol, and cocaine
• Certain diseases, such as hemolytic uremic syndrome, scleroderma, thrombotic thrombocytopenic purpura, rhabdomyolysis, and tumor lysis syndrome

Urine blockage in the kidneys

This may be associated with: 

• Certain cancers, like bladder, prostate, cervical, and colon cancer
• Blood clots in the urinary tract
• Kidney stones
• Enlarged prostate
• Nerve damage involving nerves that control the bladder

What are the risk factors for AKF?

AKF is typically associated with another condition(s), such as:

• Being hospitalized, especially for a serious condition 
• Advanced age
• Blockage in the blood vessels in your arms or legs
• Diabetes
• Hypertension
• Heart failure
• Kidney disease
• Liver disease
• Certain cancers and their treatments

Are there any potential complications?

Like many severe medical conditions, side effects and complications may occur. Some potential complications of AKF are:

• Fluid build-up
• Chest pain
• Muscle weakness
• Permanent kidney damage, which leads to CKD
• Death

Can it be prevented?

Most of the time, acute kidney failure is difficult to predict or prevent, but you may be able to reduce your risk by:

• Follow the instructions for over-the-counter (OTC) medications, especially aspirin, acetaminophen (Tylenol), ibuprofen (Advil and Motrin IB), and naproxen sodium (Aleve). Taking too much of these types of medications may increase the risk of kidney injury. 
• Work with your care team to manage your CKD and any other chronic conditions. Stay on track with your treatment plan and follow your doctor’s recommendations.
• Prioritize having a healthy lifestyle. Adequate physical activity, a well-balanced diet, and moderate amounts of alcohol (if any) are key to maintaining good health. 

*Mayo Clinic. (2020, July 23). Acute kidney failure. https://www.mayoclinic.org/diseases-conditions/kidney-failure/symptoms-causes/syc-20369048