When a client arrives at the emergency department with complaints of asthenia, malaise, headache, weight gain, and decreased urination, the key factor is urine retention. This clue alone can lead to a diagnosis of acute renal failure. Acute kidney failure is the loss of the ability to filter, eliminate, and balance fluids and electrolytes in your body. There are three types of causes, all of which require a treatment plan. PrerenalPrerenal is a disturbance that occurs before reaching the kidneys and is usually caused by inadequate blood flow. It prevents blood from reaching the kidneys to be filtered there. According to Remedy's Health Communities (2001), "Some notable causes of prerenal AKI are dehydration, heart failure, sepsis (severe infection), and significant blood loss." » Pre-existing medical conditions may also be associated and factor into the cause. For example, atherosclerosis (hardening of the arteries with fatty deposits) can reduce blood flow (Remedy's Health Communities, 2011). Not getting the right amount of fluids can prompt an ambulance and lead to prerenal AKI. The use of diuretics can eliminate large amounts of fluid, also dehydrating the patient and causing fluid and electrolyte imbalance. Patients with heart disease take diuretics to prevent other problems, putting them at higher risk of prerenal problems. Some other risk factors may include hemorrhage, cardiac dysrhythmias, anaphylaxis and embolism. Intrarenal/intrinsicThis acute renal failure occurs in the kidneys. As Remedy's Health Communites (2001) states, “Intrinsic AKI accounts for approximately 40% of cases of acute kidney injury. » Three classifications of intrarenal AKI are vascular disease, tubule disease...... middle of paper ...... intake and output, weight loss, stable vital signs, normal breathing sounds, and absence of distended jugular veins. These goals will help relieve the patient's symptoms and possibly allow for increased urination. Diet Health Club Reference List. (January 14, 2014). Retrieved from http://www.diethealthclub.com/health-issues-and-diet/acute-renal-failure/acute-renal-failure-diet.htmlM.D., KL (December 5, 2012). American Journal of Nephrology. Obesity and kidney transplant candidates: how big is too big for transplants?, 11.MALAY AGRAWAL, M. (April 1, 2000). American family physician. Retrieved from http://www.aafp.org/afp/2000/0401/p2077.htmlMedline Plus. (2011). Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/000501.htmRemedy's Health Communities. (May 1, 2011). Retrieved from http://www.healthcommunities.com/acute-renal-failure/overview-of-arf.shtml