Intrinsic or intrarenal
acute renal failure (ARF) occurs when direct damage to
the kidneys causes a sudden loss in kidney function. The treatment of intrinsic
acute renal failure includes identifying and correcting the cause of the renal
failure. The most common causes of intrinsic acute renal failure are acute
tubular necrosis (ATN), acute glomerulonephritis (AGN), and acute interstitial
nephritis (AIN).
Acute tubular necrosis (ATN)
Acute tubular necrosis (ATN) is a condition in which the small
filtering tubes in the kidney are destroyed. ATN is a common cause of intrinsic
acute renal failure often seen in people who are already hospitalized. ATN may
occur because of:
- Decreased blood flow in the kidneys. Decreased
blood flow may be caused by:
- Surgery, especially cardiovascular or
abdominal surgery.
- Direct injury to the kidney.
- Severe
burns.
- Severe muscle injury or extreme physical exertion.
- Substances, such as
medications that are toxic to the kidneys. Many
substances that are not toxic to the kidneys in a healthy person may become
toxic in a person who has existing kidney problems or another condition that
increases his or her risk of acute renal failure, such as heart failure,
diabetes, or multiple myeloma.
Acute glomerulonephritis (AGN)
Glomerulonephritis is a condition in which the tiny blood vessels
in the kidneys become inflamed and damaged. Damaged glomeruli do not filter
blood properly.
Acute glomerulonephritis may be caused by an abnormal
immune system response. Some specific conditions that
cause acute glomerulonephritis include:
Symptoms of glomerulonephritis include blood and protein in the
urine, high blood pressure, and swelling caused by fluid retention
(edema).
Acute interstitial nephritis (AIN)
Acute interstitial nephritis (AIN) is inflammation of the kidneys.
It is usually caused by a
medication, such as an
antibiotic or a
nonsteroidal anti-inflammatory drug like aspirin or
ibuprofen. But AIN may also be caused by a streptococcal, viral, or
Legionella infection.
Symptoms of AIN include a skin rash, fever, and an abnormal
sediment in the urine.
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