Patient Education: Acute Renal Failure
What It Is
Acute Renal Failure (also called Acute Kidney Injury, or AKI) happens when your kidneys suddenly stop working well. Your kidneys normally clean waste from your blood, balance fluids, and help control blood pressure. When they are injured, waste builds up in your body and can make you very sick. This can happen within hours or days.
Causes and Risk Factors
Causes:
Severe infection (sepsis)
Severe dehydration
Loss of a lot of blood
Blockage in the urinary tract (kidney stones, enlarged prostate)
Certain medicines that harm kidneys (NSAIDs like ibuprofen, some antibiotics, contrast dyes from X-rays)
Low blood flow to the kidneys from heart failure or shock
Risk Factors:
Age 65 or older
Chronic kidney disease
Diabetes
High blood pressure
Heart disease
Recent major surgery
Severe burns or trauma
Signs and Symptoms
Early warning signs:
Decreased amount of urine
Swelling in feet, ankles, or around eyes
Fatigue or weakness
Other symptoms:
Confusion or trouble thinking clearly
Nausea or vomiting
Shortness of breath
Irregular heartbeat
Pain or pressure in the chest
Seizures or coma (in severe cases)
Complications if Untreated or Not Following Care Plan
Fluid buildup in the lungs (pulmonary edema)
Dangerous heart rhythms (arrhythmias)
Permanent kidney damage or chronic kidney disease
Death in severe cases
Treatment and Self-Care Measures
Treatment in the hospital may include:
IV fluids to restore balance
Medicines to control potassium and other electrolytes
Dialysis (a machine that cleans your blood) if kidneys are not working
Stopping harmful medicines
Treating the cause (infection, blockage, dehydration)
Self-Care at Home:
Take medicines exactly as prescribed
Drink fluids only as directed by your doctor (too much or too little can be harmful)
Monitor and record your weight daily — sudden weight gain may mean fluid buildup
Keep track of how much urine you pass each day if instructed
Common Types of Medications
Diuretics (furosemide, bumetanide): Help remove extra fluid. Side effects: low potassium, dizziness, dehydration.
Blood pressure medicines (ACE inhibitors, ARBs): Help protect kidneys and heart. Side effects: low blood pressure, cough, high potassium.
Electrolyte binders (sodium polystyrene sulfonate): Help lower high potassium. Side effects: nausea, constipation, diarrhea.
Antibiotics (if infection is present): Kill bacteria. Side effects: stomach upset, allergic reaction.
Dietary Needs
Limit sodium (salt) to reduce swelling and blood pressure.
Limit potassium (bananas, oranges, tomatoes) if levels are high.
Limit phosphorus (nuts, dairy, dark sodas) if levels are high.
Eat more low-potassium fruits and vegetables if recommended.
Follow your doctor’s instructions on fluid intake.
Lifestyle Changes
Avoid over-the-counter pain medicines like ibuprofen unless approved.
Avoid alcohol and illegal drugs.
Quit smoking — it harms blood vessels and kidneys.
Keep blood sugar and blood pressure under control.
Keep all medical appointments for lab tests.
Safety Considerations
Check with your doctor before taking any new medicine, supplement, or herbal product.
Stand up slowly to prevent dizziness if on blood pressure medicines or diuretics.
Do not skip lab appointments — changes in labs can show problems before you feel symptoms.
Prevention and Maintenance Tips
Stay hydrated but follow your fluid limits.
Avoid infections — wash hands, stay up to date on vaccines.
Manage chronic conditions like diabetes and high blood pressure.
Report symptoms early — waiting can cause kidney damage to worsen quickly.
When to Call for Help
Call Your Home Health Nurse or Doctor If:
You have swelling in your legs, ankles, or around your eyes.
You urinate much less than usual or not at all in 12 hours.
You feel weak, tired, or confused.
You notice sudden weight gain (more than 2–3 lbs in a day).
You have nausea, vomiting, or loss of appetite.
Your blood pressure is higher or lower than your usual range.
Call 911 or Go to the Emergency Room If:
You have chest pain or pressure.
You have trouble breathing or severe shortness of breath.
You are confused, faint, or very drowsy.
You have seizures.
You notice your heart beating very fast, very slow, or irregularly.
© 2025 Judith Regan / K.N.O.W. – Knowledge for Nurturing Optimal Well-Being. All rights reserved. | Educational use only | Not a substitute for medical advice | In emergencies call 911
Patient Homework / Assessment
Instructions: Circle True or False for each statement. Correct any false statements.
True / False – Acute renal failure means the kidneys stop working suddenly.
True / False – One cause of acute renal failure can be severe dehydration.
True / False – Swelling in the ankles is a sign of fluid buildup.
True / False – Ibuprofen is always safe to take for pain in kidney failure.
True / False – Limiting salt can help control swelling and blood pressure.
True / False – Acute renal failure always causes permanent kidney damage.
True / False – Dialysis is sometimes needed if the kidneys are not working.
True / False – Recording daily weight can help detect fluid buildup.
True / False – High potassium can cause dangerous heart rhythms.
True / False – Bananas are a good food choice when potassium is high.
True / False – You should skip lab appointments if you feel fine.
True / False – Fluid intake should be as much as you want.
True / False – Quitting smoking helps protect kidney health.
True / False – Confusion can be a sign of acute renal failure.
True / False – Antibiotics may be used if infection caused the kidney injury.
True / False – It is safe to start herbal supplements without asking your doctor.
True / False – Staying within fluid limits can prevent complications.
True / False – Shortness of breath can be a sign of fluid in the lungs.
True / False – High blood pressure can harm the kidneys.
True / False – You should call 911 for chest pain or trouble breathing.
Individualized Patient Questions
Do you know what caused your acute renal failure?
What was your last blood potassium level, and was it in the safe range?
What is your daily fluid limit from your doctor?
Are you following a low-sodium or low-potassium diet?
Do you take any over-the-counter medicines or supplements?
Have you had dialysis, and if so, how often?
Have you had swelling or sudden weight gain this week?
Do you know your target blood pressure range?
Have you noticed changes in your urine amount or color?
Do you understand when to call your nurse versus the ER?
Answer Key with Explanations
True – Acute renal failure is a sudden loss of kidney function.
True – Severe dehydration is a common cause.
True – Swelling is a sign of fluid buildup in the body.
False – Ibuprofen can harm kidneys and should be avoided unless approved.
True – Less salt helps reduce swelling and control blood pressure.
False – Acute renal failure can be temporary if treated quickly.
True – Dialysis may be needed until kidneys recover.
True – Weight gain can mean fluid buildup.
True – High potassium can cause life-threatening heart problems.
False – Bananas are high in potassium and should be avoided if levels are high.
False – Lab appointments are important even if you feel fine.
False – Too much fluid can be dangerous in kidney failure.
True – Smoking damages blood vessels and kidneys.
True – Confusion can happen when waste builds up in the blood.
True – Infection-caused kidney injury may require antibiotics.
False – Some supplements can harm kidneys or interact with medicines.
True – Following fluid limits can help prevent heart and lung problems.
True – Fluid in the lungs can make breathing hard.
True – High blood pressure is a major cause of kidney damage.
True – These symptoms can be life-threatening and need emergency help.