KIDNEY FAILURE

WHAT CAUSES RENAL 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 categorised based on where the injury has occurred.
Prerenal causes (before the kidney) are due to the decreased blood supply to the kidneys. Examples of prerenal causes are
· Hypovolemia (low blood volume) due to blood loss.
· Dehydration from loss of body fluid( vomiting, diarrhoea, sweating and fever)
· Medication, for example, diuretics may cause excessive water loss
· Loss of blood supply to the kidney due to obstruction of the renal artery or vein.

Renal causes (damage directly to the kidneys) include
· Sepsis: the body’s immune system is overwhelmed from infection and causes inflammation and shutdown of the kidneys. This does not occur with urinary tract infections
· Medications: some medications are toxic to the kidney, including nonsteroidal anti –inflammatory drugs like naproxen. Others are antibiotics, 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 degeneration products of the muscle fibers clog the filtering system of the kidneys. often occurring because of trauma and crush injuries.
· Multiple myeloma
· Acute glomerulonephritis-inflammation o the glomeruli.

Post renal causes (after the kidney) are due to the factors that affect the outflow of the urine
· Obstruction of the bladder or the ureters can cause back pressure when there is no place for the urine to go as the kidneys continue to work. When the pressure increases enough, the kidneys 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

Chronic renal failure develops over months and years. the most common renal failures are related:
· Poor controlled diabetes.
· Poor controlled high blood pressure.