<s>[INST] sir My father admit in hospital and he is seffring from dialiysis. He has done 2 time dialiysis. But creatinine level till now 6.5 and BU 72 sir i like to inform you that my father admit in hospital last sunday for only vometting and loss motion and treatment start but after 2 days not make urine. Doctor says some sweling in kidney we have done ultrasound and find both kidney isnormal in size with increased enchogenicity. No calculus or back pressur changes seen.C-M differentiation is present. And prostrate is enlarged weight 25 gms. Doctor suggest us to should be some more dialysis done. No any mediacals history of my father.Sir kindly guide us for this and do the better option in thia case. Sandeep pandey 0000 [/INST] Hi Mr. Sandeep Panda, After going through your fathers' case there is Acute Renal Failure (ARF)/ Acute Kidney Injury (AKA) (Decreased OR absent urine production and normal size kidneys with increase echogenicity are indicator of AKA). For AKA to develop there is underlying cause in most of the cases like1) Severe deny Chat Doctor.  (May because in your father) 2) Infection.3) Persistent low BP which decreases blood supply to kidney. In your fathers' case I want to know-1) Number of episodes of loose nations and vomiting at the time of presentation.2) Any recent use of painkiller medicines or other nephrotoxic medicines.3) Habits like smoking and alcohol. Need for Hemodialysis depends on on-1) Amount of Urine production daily.2) Serum electrolyte mainly Potassium.3) Serum Creatinine level.4) Arterial Blood Gas (ABG) analysis which denote degree of acid accumulation in blood.5) Signs of water retention like breathing difficulty, swelling over body, puffiness of face. Anuria (no urine production) requires Hemodialysis as in your fathers case. So try to relief on four doctor. In most of the cases of AKA kidney function returns to normal over time till that time there may need for hemodialysis depending upon above-mentioned facts. Rarely AKA may progress to CKD (Chronic Kidney Disease) </s>