Section: Information In-depth
Acute renal failure (ARF) is a life-threatening disorder that can affect dogs of any age.
Acute renal failure may be caused by decreased blood flow to the kidneys (called ischemia) or exposure to certain drugs or chemicals that are toxic to the kidneys.
Low blood flow to the kidneys may occur during anesthesia and surgery, and some drugs such as the non-steroidal anti-inflammatory agents like ibuprofen may also cause ARF by reducing blood flow to certain parts of the kidneys. Other causes of reduced blood flow to the kidneys include severe dehydration, shock, poor heart function, heat stroke and overwhelming infection (sepsis).
Many toxins can damage the kidneys and lead to ARF. Probably most important is ethylene glycol, which is the active ingredient of anti-freeze. Some antibiotics, especially a class of injectable antibiotics known as aminoglycosides, can cause damage to the tubules of the kidney and ARF. High blood calcium concentration likewise can damage the kidneys. Heavy metals (e.g. lead, arsenic), contrast dyes used for certain X-ray procedures, and some anesthetics also can damage the kidneys. An important toxin that specifically affects the kidneys of dogs is the Easter Lily. Dogs should never be allowed access to this group of plants. Some older drugs used to treat heartworms (thiacetarsamide) and fungal infections (amphotericin B) also are toxic to the kidneys.
Acute bacterial infection of the kidneys (called pyelonephritis) also can produce ARF.
Rare causes of ARF include glomerulonephritis (acute inflammation of the microscopic filtering devices of the kidney called glomeruli), glomerular amyloidosis (deposition of an insoluble type of protein in the kidney), disseminated intravascular coagulation (a body-wide clotting disorder), obstruction by blood clots of the arteries going to the kidneys, and hemolytic-uremic syndrome (liver and kidney failure caused by a specific strain of the bacteria E. coli).
Urinary obstruction is a type of reversible ARF that is treated by relieving the obstruction.
The most common causes of death during treatment of ARF are high blood potassium concentration, acid-base disturbances, very high concentrations of waste products in the blood that do not improve with fluid therapy and excessive administration of fluids with fluid accumulation in the lungs.
Animals unable to produce urine despite medical treatment have little chance for survival without peritoneal dialysis (infusion and removal of fluid into the abdominal cavity to remove waste products from the body). Hemodialysis can be performed in animals but is only available at selected referral hospitals and is very costly.
The prognosis for recovery of kidney function in ARF depends on the severity of the kidney damage, the underlying cause of ARF and supportive treatment.
Other medical problems can lead to symptoms similar to those encountered in ARF. A thorough medical evaluation is needed to diagnose ARF including laboratory testing and diagnostic imaging (X-rays or ultrasound). Warning signs that owners may see in pets with ARF include complete loss of appetite, marked lethargy, and vomiting. Unfortunately, these symptoms are very non-specific and may be caused by many other disease conditions. If is important to consult your veterinarian promptly.
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