13/08/2026
Acute kidney failure, now called acute kidney injury (ALI), is a rapid decline in kidney function over hours to days, resulting in the inability to properly eliminate metabolic waste, toxins, and water. Unlike chronic kidney disease, some cases of acute kidney injury may show partial or even complete recovery of kidney function with rapid, standardized treatment; however, late treatment may lead to chronic renal failure and put the patient's life at risk.
Main causes of acute kidney injury
Clinically, there are three main categories, and accurate identification of the root cause is crucial for treatment:
1. Prerenal causes (insufficient blood supply to the kidneys, the most common cause)
Dehydration, heavy bleeding, severe vomiting and diarrhea, shock, heart failure, and profound hypotension can all cause a sudden reduction in renal blood flow.
2. Acute renal failure (renal parenchymal damage)
Drug-induced nephrotoxicity (pain relievers, certain antibiotics, traditional herbal medicines), serious infections, rhabdomyolysis, glomerulonephritis, and tubular necrosis.
3. Postrenal acute renal failure (urinary tract obstruction)
Kidney stones, tumors, and benign prostatic hyperplasia can block the flow of urine and cause reverse pressure on the kidneys.
Treat the underlying cause (priority)
Prerenal acute renal failure: Restoration of renal perfusion and blood supply.
For patients with dehydration or bleeding, administer fluids and blood transfusions to correct hypotension and shock; for patients with heart failure, adapt cardiac therapy and improve circulation. In most cases of early prerenal acute kidney injury, renal function improves rapidly upon restoration of circulation.
Acute renal failure: Discontinue nephrotoxic factors.
Immediately stop taking suspected nephrotoxic drugs and traditional therapies/nutraceuticals; treat serious infections. Rhabdomyolysis requires massive fluid resuscitation to alkalinize the urine and prevent myoglo
