Acute Kidney Injury

Overview of Acute Kidney Injury

Acute Kidney Failure or AKI develops when serious damage to the kidneys is done. It most commonly occurs in intensive care patients at the hospital.

Kidney diseases are an indication that kidneys are damaged and unable to perform their function. When kidneys are damaged they cannot filter their blood properly. Diabetic and hypertensive patients are at a greater risk for kidney disease.
AKI also known as Acute Kidney Injury (گردوں کی شدید ناکامی) happens when the kidneys stop working over a few days or a few hours. It is also termed acute kidney failure or acute renal failure.AKI is both fatal and reversible.
In AKI, kidneys are unable to filter waste products from the blood. This allows the waste materials to accumulate in the body at a dangerous level. This throws the chemical balance of the blood. AKI most commonly occurs in critically-ill patients.

Prevalence of AKI

AKI cases per annum are about 13.3 million globally. The incidence rate of AKI during hospitalization is 2.5 percentIn Pakistan, this incidence rate is 21 percent in critically ill patients after myocardial infarction. In Islamabad, this rate was found to be 68.55 percent with a mortality rate of 18.55 percent.

Doctors Treating Acute Kidney Injury

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Signs and Symptoms of Acute Kidney Injury

Signs and symptoms of AKI include:

  • Fluid retention, swelling in legs, feet, and ankles
  • Decreased urine output
  • Shortness of breath
  • Nausea
  • Weakness
  • Fatigue
  • Confusion
  • Pain or pressure in the chest
  • Seizures or coma (in case of severe AKI)

Types of Acute Kidney Injury

Causes of Acute Kidney Injury

Acute kidney injury is the indicator that kidneys are damaged suddenly. The cause of acute kidney injury is as follows:

  • Injury to the kidneys
  • Blockage in ureters
  • Less blood flow through the kidneys

Less Blood Flow to the Kidneys
Less or impaired blood flow to the kidneys may be due to following: 

  • Blood loss
  • Fluid loss
  • Infection
  • Blood pressure medications
  • Use of blood thinners
  • Heart disease
  • Heart attack
  • Dehydration (severe)
  • Burns (severe)
  • Anaphylaxis

Diseases & Conditions Causing AKI

Following are the diseases and conditions that can cause acute kidney failure:

  • Inflammation of glomeruli
  • Infection
  • Medications
  • Blood clots in the veins and arteries
  • Lupus
  • Scleroderma
  • Hemolytic uremic syndrome
  • Heavy metals toxins
  • Cocaine
  • Rhabdomyolysis
  • Tumor lysis syndrome

Other diseases that cause AKI by blocking the passage of urine out of the body include:

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Risk Factors of Acute Kidney Injury

Risk factors leading to acute kidney injury include:

  • Advanced age
  • Hypertension
  • Diabetes
  • Kidney diseases
  • Cancers
  • Heart diseases
  • Critically ill and hospitalized
  • Peripheral artery disease

Health Complications of AKI

Acute kidney failure can cause many health complications including:

 

  • Chest pain
  • Muscle weakness
  • Pulmonary edema (fluid buildup in the lungs)
  • Hyperkalemia
  • Permanent kidney damage
  • Eventual death

 

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Prevention

The preventive measure for acute kidney injury is that the person should avoid hypovolaemia as well as the use of nephrotoxic drugs. Make sure to drink lots of water to prevent dehydration.

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Diagnosis

Various tests are recommended for a proper diagnosis, including:

Treatment of Acute Kidney Injury | When to Consult a Doctor

Acute kidney injury cannot be treated at home. This requires hospitalization until the condition is stabilized. 

The underlying cause or illness causing AKI is treated first, further treatment also depends on the cause. Treatment methods include:

  1. IV Fluids

IV fluids are given to balance the dehydration and loss of fluid. In case, there is a fluid buildup diuretics are given to expel the extra fluids in the body.

  1. Medications

In the case of hyperkalemia, medications to control potassium are given. A high level of potassium can cause irregular heartbeat and extreme muscle weakness.

Medications to reverse hypocalcemia are also given. 

  1. Hemodialysis

Dialysis is done temporarily until the kidneys can fully recover. Dialysis is done at least thrice a week. This removes the toxins buildup in the body and removes excess fluid allowing the kidneys to heal.

Since acute kidney injury is diagnosed when the kidneys are damaged, consulting a nephrologist becomes necessary.