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PDF | Acute renal failure is a common condition, frequently encountered in both community practice and hospital inpatients. While it remains a. When there is an acute injury to the kidney, as in acute tubular necrosis, sodium reabsorption is impaired and there is an increase in sodium excretionreduced kidney size on imaging (bipolar diameter < 10 cm on renal ultrasound). However, kidney size may not be reduced if the original renal disease was. ?Acute renal failure. ?Severe High anion gap metabolic acidosis. ?Toxin-induced hepatitis. ?Encephalopathy. ?Blindness