When a client comes to the emergency room complaining of fatigue, malaise, headache, weight gain, and decreased urination, the key factor is urinary retention. This clue alone can lead to a diagnosis of acute renal failure. Acute kidney failure is the loss of the ability to filter, remove and balance fluids and electrolytes in the body. There are three types of causes, all of which have a necessary treatment plan. Prerenal Prerenal is a disruption that occurs before reaching the kidneys and is usually caused by inadequate blood circulation. It prevents blood from reaching the kidneys to be filtered. According to Remedy's Health Communities (2001), "Some important causes of prerenal ARF are dehydration, heart failure, sepsis (serious infection), and severe blood loss." Pre-existing medical conditions may also be associated and impact the cause. For example, atherosclerosis (hardening of the arteries with fatty deposits) can reduce blood flow (Remedy's Health Communities, 2011). Not taking the right amount of fluids can cause ambush and lead to prerenal ARF. The use of diuretics can eliminate large amounts of fluid, dehydrating the patient and causing a fluid and electrolyte imbalance. Patients with heart disease take diuretics to prevent other problems, which puts them at greater risk of prerenal problems. Some other risk factors may include bleeding, cardiac arrhythmias, anaphylaxis, and embolism. Intrarenal/intrinsic This acute renal failure occurs within the kidneys. As stated by Remedy's Health Communites (2001), "intrinsic ARF accounts for approximately 40% of cases of acute renal failure." Three classifications of intrarenal ARF are vascular disease, tubular disease… middle of paper… withdrawal and output, weight loss, stable vital signs, normal breath sounds, and no distended jugular veins. These goals will help with the patient's symptoms and eventually allow for increased urination. Diet Health Club Reference List. (2014, January 14). Retrieved from http://www.diethealthclub.com/health-issues-and-diet/acute-renal-failure/acute-renal-failure-diet.htmlM.D., K.L. (2012, December 5). American Journal of Nephrology. Obesity and kidney transplant candidates: how old is too old for transplants?, 11.MALAY AGRAWAL, M. (2000, April 1). American family doctor. 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 Health Communities. (2011, May 1). Retrieved from http://www.healthcommunities.com/acute-renal-failure/overview-of-arf.shtml