Everything You Need To Know About Acute Kidney Injury

by Dr. Mamidi Pranith Ram | Jan 04, 2023 | Nephrology

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1. What is an acute kidney injury?

2. What are the causes?

3. What are the symptoms?

4. What are the risk factors for AKI?

5. How is AKI diagnosed?

6. What are the treatment options?

7. What are the complications of AKI?

8. Are preventive measures effective in reducing the risk of AKI?

9. Do I need follow-up care?

Acute kidney injury (AKI) is a serious condition that can lead to long-term kidney damage and even death. It must be treated right away to restore normal kidney function and prevent long-term kidney damage.

This blog will provide you with a comprehensive overview of AKI, including the signs, symptoms, causes, diagnosis, and treatment. Continue reading to learn more.

What is an acute kidney injury?

Acute kidney injury (AKI), also known as acute renal failure (ARF), occurs when your kidneys suddenly stop working properly. It can range from a minor loss of kidney function to total kidney failure, which occurs within hours or days.

Normally, kidneys filter waste products and maintain fluid and electrolyte balance. So in AKI, as the kidneys don’t function properly, it results in the buildup of waste products in your blood and a fluid imbalance in your body.

AKI can affect the function of other organs such as the brain, heart, and lungs. And hence, it is common for some patients with AKI to be hospitalised in intensive care in a critically ill state.

What are the causes?

AKI may occur due to the following causes:

Reduced blood flow to the kidneys as a result of hypovolemia associated with acute gastroenteritis (which decreases the blood volume), heart failure (the heart’s inability to pump enough blood to the kidneys), or sepsis (a systemic bacterial infection that affects blood flow).
Kidney damage, due to intrinsic kidney problems, such as inflammation and injury caused by infections, certain medications, and autoimmune conditions.
Urine blockage caused by a blockage in kidney drainage, such as an enlarged prostate, kidney stones, or cancer.

Reduced blood volume as a result of excessive bleeding, vomiting or diarrhoea, or severe dehydration

Certain medications, such as ACE inhibitors, diuretics, or NSAIDs, reduce blood pressure and affect the blood flow to the kidneys.

AKI can lead to complications like electrolyte imbalances, fluid overload, or a higher risk of cardiovascular events.

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What are the symptoms?

Mild cases of AKI may be asymptomatic, and you may be diagnosed when tested for another condition.

More severe forms of AKI, on the other hand, exhibit the following signs and symptoms:

Reduced or lack of urination
Blood in the urine (red or brown discolouration)
Swelling in the extremities (legs or feet)
Vomiting
Lack of appetite
Fatigue
Confusion
Seizures (fits)
Shortness of breath
Coma

If you experience any of the symptoms listed above, contact your doctor.

If you are already in the hospital, inform your doctor or nurse if you are experiencing any of these symptoms.

What are the risk factors for AKI?

Risk factors for AKI include age, pre-existing kidney disease and other comorbid conditions like diabetes and hypertension, certain medications, dehydration, sepsis, and certain medical procedures.

These risk factors can increase the risk of AKI by causing damage to the kidneys, reducing blood flow to the kidneys, obstructing the urine flow, or increasing the amount of toxins in the blood that the kidneys must filter.

How is AKI diagnosed?

AKI should be identified as soon as possible because it can result in acute renal failure or even chronic kidney disease.

The following tests may be performed depending on your clinical condition and the symptoms you are experiencing:

You will be monitored for how much urine you pass each day (urine output) to help identify the severity of renal failure.
A urinalysis to check for indications of kidney failure.
In addition to blood tests for protein, additional blood tests for creatinine, urea nitrogen, phosphorus, and potassium should be performed to examine kidney function.
Your blood test will also help determine your glomerular filtration rate (GFR), which you can use to determine how well your kidneys are functioning.
Imaging tests, like ultrasounds, can help check for any abnormalities within and outside the kidneys.
In some circumstances, you may be required to undergo a procedure called biopsy, in which a very small piece of your kidney is removed with a special needle and examined under a microscope to examine for the presence of cancer.

What are the treatment options?

Treatment options for acute kidney failure typically include the following:

Treatments for underlying kidney problems: Identifying and treating the underlying illness or injury that originally damaged your kidneys.
Treatments to balance the amount of fluids in your blood: If you are dehydrated, your doctor may recommend intravenous (IV) fluids and if you have too much fluid, your doctor may recommend medications (diuretics) to expel extra fluids from your body.
Dialysis to remove toxins from your blood: If toxins build up in your blood, you may need temporary dialysis to help remove toxins and excess fluids from your body while your kidneys heal.

You may require treatments to ensure your body has the proper amount of fluid, salt, and nutrients until your kidneys can function normally again. These treatments may include medication as well as dietary changes.

People with an acute kidney injury must usually avoid or limit foods high in sodium (salt), potassium, and phosphorus. A dietitian can assist you in planning healthy meals that contain the appropriate amounts of each nutrient.

You may also need to limit the amount of water and fluid you consume each day.

What are the complications of AKI?

The complications of AKI can include electrolyte imbalances, fluid overload, metabolic acidosis, anaemia, an increased risk of infection, and an increased risk of cardiovascular events.

In severe cases, it can lead to kidney failure, which requires dialysis or a kidney transplant.

Are preventive measures effective in reducing the risk of AKI?

Yes, preventive measures can help reduce the risk of AKI. These measures include the following:

Maintain a healthy lifestyle, including regular exercise and a balanced diet.
Monitor blood pressure and cholesterol levels.
Avoid taking over-the-counter medications without consulting a doctor.
Drink plenty of fluids to prevent dehydration.
Avoid using non-steroidal anti-inflammatory drugs (NSAIDs) for long periods of time. Avoid using herbal supplements without consulting a doctor.
Avoid smoking and drinking alcohol.
Monitor any existing medical conditions, such as diabetes or high blood pressure.
Avoid taking drugs that can be toxic to the kidneys, such as certain antibiotics and chemotherapy drugs.

Additionally, regular check-ups with a healthcare provider can help identify any potential risk factors for AKI.

Seek medical attention if you experience any symptoms of acute kidney injury, such as decreased urine output, swelling, fatigue, or confusion.

Do I need follow-up care?

As you recover from a kidney injury, you will undergo additional lab tests. This will enable your doctor to keep track of how well your kidneys are functioning.

Even though it may be challenging to predict or prevent AKI, leading a healthy lifestyle and caring for your kidneys can be beneficial. Consult your doctor about how to prevent AKI if you suffer from any of these conditions.