Acute kidney damage occurs quickly, almost as if it comes out of nowhere, but the
reality is that the damage begins long before, at least for anyone paying sufficient
attention to the right signs.

The kidneys are extremely susceptible to three types of damage.

The first is a reduction of blood flow. If the blood flow to the kidneys is reduced to a
level below a certain threshold, whether by severe dehydration, blood loss, heart failure,
septic shock, or a reduction of blood pressure for whatever reason, the kidneys shut
down as a protective mechanism.

The second form of damage comes from toxins. Certain drugs, such as NSAIDs, aminoglycoside antibiotics, and the dye used for imaging studies, can damage the
tubular cells, which actually do the filtering, sometimes as quickly as a few hours.

Finally, there is damage from a blocked ureter, whether by a kidney stone, a tumor, or a
swollen prostate, and the pressure that the backed-up urine puts on the kidneys.

The reason acute kidney damage is so difficult to deal with is the tremendous reserve
the kidneys have.

As much as 75% of the kidneys' ability to function can be destroyed before there are
even the slightest changes in blood chemistry, meaning the damage occurs gradually but
the kidneys compensate for the damage until the point at which the damage cannot be
compensated for, and then the kidneys fail very quickly.

One of the more positive differences between acute and chronic kidney failure is the
ability of the kidneys to heal.

While the damage to the kidneys from chronic kidney failure is permanent, the damage
to the kidneys from acute kidney failure can heal to a significant degree, provided the
underlying reason for the failure is identified and corrected quickly.

This window of healing capability is limited to a range of hours rather than weeks.

Full story:
https://www.quora.com/Why-is-there-a-sudden-kidney-failure

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