Causes of Acute Renal Failure & Chronic Renal Insufficiency

Chronic and acute renal failure stem from different root causes. While acute renal failure is more likely to develop due to sudden injury, infection or rapidly developing medical conditions, chronic renal insufficiency tends to result from gradual damage caused by diabetes, cancer, or hypertension (high blood pressure).

Causes of Acute Renal Failure

Three separate types of acute renal failure (ARF) have been identified: pre-renal, intrinsic, and post-renal.

Pre-renal ARF occurs when low blood circulation leads to significantly low urine flow, and is often caused by dehydration, shock, or low cardiac output (as seen in heart failure). Ascites can also be responsible for pre-renal ARF. Ascites is an accumulation of fluid in the abdomen, which redirects fluid that would otherwise be used to produce urine. Liver disease often causes ascites.

Intrinsic ARF is caused by injury to the kidneys' tubular network — tiny tubes that filter the blood in the kidney. Certain toxins can damage the tubular system, including solvents, some antibiotics, and other drugs. Kidney stones and a condition known as ischemia can injure the system. Ischemia results from a deficient blood supply to an organ. Blood flow obstructions cause a lack of red blood cells and oxygen delivery to the affected area and can lead to permanent scarring of the tissue and loss of function.

Intrinsic ARF may also be caused by glomerulonephritis. Glomerulonephritis is an inflammation of the glomeruli — small blood vessels in the kidney nephrons (the functional units that filter the blood). Glomerulonephritis may be the result of infection, or of immune system disorders such as systemic lupus erythematosus.

Postrenal ARF is an obstruction of the kidney's outflow tract. The condition has been linked to benign prostatic hyperplasia (BPH), or enlarged prostate. Prostate, cervix, bladder or colorectal cancer may also block the outflow. Bilateral renal calculi (kidney stones present in both kidneys) may also be responsible. Renal vein thrombosis (blood clots) is another possible cause, and may arise in conjunction with kidney cancer.

Causes of Chronic Renal Insufficiency

Chronic renal insufficiency takes longer to develop than ARF, and is associated with diseases that damage the body over longer periods of time. Of these, diabetes, hypertension, kidney diseases, and cancer are the most common. Diabetes and hypertension are responsible for over two thirds of all CRF cases.

Other causes of CRF include:

kidney stones
infections
glomerulonephritis.

Hemolytic Uremic Syndrome & Children

Hemolytic uremic syndrome is the leading cause of acute renal failure in children. The disorder has been traced to gastrointestinal infections. E. coli is a common culprit for GI infection, and is often present in undercooked meat. Symptoms begin with vomiting, diarrhea, fatigue, and irritability. As the syndrome progresses, urine flow slows or completely ceases, causing ARF.

Causes of Renal Failure

A number of health conditions can contribute to the development of renal failure or renal insufficiency. These include:

bladder cancer
benign prostatic hyperplasia (BPH)
colorectal tumor
diabetes
hypertension
kidney cancer
kidney stones
liver disorders
prostate cancer.

Tips for Preventing Kidney Failure

Don't smoke.
Exercise regularly.
Maintain proper hydration levels.
Maintain a healthy blood pressure.
Control blood sugar levels if you are diabetic.
Avoid excessive use of anti-inflammatory drugs.

Resources

Beers, M. H., & Berkow, R. (ed). Acute renal failure. The Merck Manual of Diagnosis and Therapy, 17th Edition. Merck Research Laboratories, NJ, 1999.

Beers, M. H., & Berkow, R. (ed). Chronic renal failure. The Merck Manual of Diagnosis and Therapy, 17th Edition. Merck Research Laboratories, NJ, 1999.

U.S. National Library of Medicine. (updated 2002). Acute renal failure. MedlinePlus Medical Encyclopedia.

U.S. National Library of Medicine. (updated 2003). Chronic renal failure. MedlinePlus Medical Encyclopedia.