The kidneys are a pair of organs found in the lower back of the body. There’s one kidney on either side of your spine. They will filter your blood and eliminate toxins from your body. Kidneys are transmitting toxins to your bladder, where your body will later expel toxins during urination. i.e. excretory, regulatory, endocrine and metabolic. Excretory function involves removal of wastes and drugs from body. Regulatory function is concerned with control of body water and electrolyte balance. Endocrine includes production of various hormones and metabolic function is metabolism of Vitamin D and proteins. All of these functions are deranged in case of insult to kidney which may be acute or chronic. Assessment of these functions is based on the clinical picture and laboratory investigation which are called ‘Renal Function Tests’. Besides these, urine analysis also indicates renal function status.

What is Acute and Chronic Kidney Failure?

Acute Kidney Failure (Acute Kidney Injury):

Acute renal failure — also called an acute renal failure or acute kidney injury — has developed rapidly, usually in less than a few days. Acute renal failure is most common among people who have been in hospital, especially those who are critically ill and in need of critical care. It is usually reversible. It results in increased blood urea level.  It has three types depending upon the cause i.e. Pre-renal, Renal and Post-renal. Pre-renal causes are reduced circulating blood or fluid volume throughout the body e.g. cardiac failure, immense bleeding or excessive vomiting and diarrhea. Renal causes are diseases of renal arteries, veins, infections, drugs causing insults to kidney e.g. antibiotics. Post-renal causes include any obstacle in urinary tracts e.g. kidney stones, tumor or foreign body.

Chronic Kidney Failure (Chronic Renal Disease)

The word “chronic kidney failure” means long-lasting damage to the kidneys that can worsen over time. If the damage is really severe, your kidneys will stop functioning. It is termed renal failure or end-stage renal disease (ESRD). If your kidneys fail, you will need dialysis or a kidney transplant to survive. It has got four stages. First stage is ‘reduced kidney reserve’ which includes reduction in renal function, slightly increased level of wastes and patient has got no symptom. Second stage is ‘Renal scarcity’ which is characterized by mildly elevated wastes in blood and patient is symptomatic. Third stage is ‘ kidney failure’ in which patient requires medical management and fourth stage is ‘ uremic syndrome’ in which every system of patient’s body is disturbed due to renal malfunction.

Acute Kidney VS Chronic Renal Disease

Causes:

Acute kidney failure is caused by some injury which leads to abnormal kidney functionality, which may be due to severe blood loss during accident or major surgery, acute tubular necrosis (ATN), urinary tract obstruction, dehydration or toxic kidney injury from poisons or certain medications.

Chronic kidney failure is usually due to some long term disease, such as diabetes or high blood pressure which overburdens the functions of kidney results in slowly damaging the kidney and finally malfunction. Other causes include autoimmune disorders and congenital kidney disease.

History:                                                                                       

Acute renal failure does not have any specific history of renal malfunction.

Chronic renal failure shows elevated blood wastes e.g. creatinine and urea.

Peripheral neuropathy (disturbance in sensations over limbs)

Acute kidney insult does not show peripheral neuropathy.

Chronic kidney damage show peripheral neuropathy.

 Kidney size:

In Acute renal failure, kidney size is normal.

In Chronic stage, kidneys are shrunken due to repeated insults and recovery so their size is reduced.

Bone X-ray:

In acute renal failure, there is no evidence of bone destruction on x-ray.

Chronic renal insufficiency (CRI) induces major changes in phosphorus and calcium metabolism, which often result in severe skeletal disorders, including demineralization, reduced bone tolerance, and increased risk of fractures.

Blood tests:                                                   

Acute kidney malfunction may show anemia on complete blood picture.

Chronic renal failure frequently shows anemia.

Urine examination:

Urine examination does not reveal casts in acute stages.

It shows casts on examination in chronic kidney disturbances.

Complications:

Acute renal disturbances show fluid imbalance, electrolyte disorder, malnutrition, cardiac dysfunction and bleeding.

Chronic renal failure shows nausea, vomiting, fatigue, headache, and increased blood pressure and bone deformities.

Treatment:

In Acute Renal Failure, your doctor can prescribe antibiotics to treat or prevent infections that occur at the same time. Diuretics can help your kidneys to remove fluids. Calcium and insulin will help you prevent harmful spikes in potassium levels in your blood. You might want dialysis, but it’s not always needed, and it’s probably just temporary.

There is no treatment for chronic renal failure. There are, however, steps that you can take to slow down its progression.  Removal of causes, dietary alterations, and dialysis and kidney transplant if possible.

Conclusion

Both forms of renal failure are life-threatening, because they are life-threatening conditions. They need urgent medical emergency care. One must say that the kidney is as important as the heart and needs proper care and treatment to maintain a healthy lifestyle. Which one is more life threatening according to your opinion?

https://www.healthline.com/health/acute-kidney-failure#treatment

https://www.healthline.com/health/kidney-failure#types

https://www.ncbi.nlm.nih.gov

https://www.kidneyfund.org