Renal failure can broadly be divided into two categories: acute kidney injury or chronic kidney disease. The type of renal failure is determined by the trend in the serum creatinine.
Other factors which may help differentiate acute and chronic kidney disease include the presence of anemia and the kidney size on ultrasound. Chronic kidney disease generally leads to anemia and small kidney size.
Acute kidney injury
Acute kidney injury (AKI), previously called acute renal failure (ARF), is a rapidly progressive loss of renal function, generally characterized by oliguria (decreased urine production, quantified as less than 400 mL per day in adults, less than 0.5 mL/kg/h in children or less than 1 mL/kg/h in infants); body water and body fluids disturbances; and electrolyte derangement. AKI can result from a variety of causes, generally classified as ''prerenal'', ''intrinsic'', and ''postrenal''.
An underlying cause must be identified and treated to arrest the progress, and dialysis may be necessary to bridge the time gap required for treating these fundamental causes.
Chronic kidney disease
Chronic kidney disease (CKD) can develop slowly and show few initial symptoms, be the long term result of irreversible acute disease, or be part of a disease progression.
Acute-on-chronic renal failure
Acute kidney some injuries can be present on top of chronic kidney disease. This is called acute-on-chronic renal failure (AoCRF).
The acute part of AoCRF may be reversible and the aim of treatment, as with AKI, is to return the patient to their baseline renal function, which is typically measured by serum creatinine.
AoCRF, like AKI, can be difficult to distinguish from chronic kidney disease, if the patient has not been monitored by a physician and no baseline (i.e., past) blood work is available for comparison.
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