Acute kidney injury (AKI) –
Also known as acute renal failure (ARF), is a sudden episode of kidney failure or kidney damage that
happens within a few hours or a few days.
Causes –
- Low blood pressure (called “hypotension”) or shock
- Blood or fluid loss (such as bleeding, severe diarrhea)
- Heart attack, heart failure, and other conditions leading to decreased heart function
- Due to other organ failure (e.g., heart, liver)
- Nephrotoxic drugs - Overuse of pain medicines called “NSAIDs”, which are used to reduce swelling or
relieve pain from headaches, colds, flu, and other ailments.
- Burns
- Injury
- Infection
- Cancers like multiple myeloma
- Blockage of the urinary tract – by stones, Bladder, prostate, or cervical cancer, Enlarged prostate, blood
clots in urine
Symptoms –
- Accumulation of waste products in your blood due to inability of the kidneys to excrete them
- Decrease in urine output
- Fluid balance is hampered –
- Patient may increased amount of fluid due to decreased clearance of free water, causing - Swelling in
legs, ankles, and around the eyes, shortness of breath
- Or may have signs of dehydration due to repeated vomiting or loose stool (if that’s the cause of AKI)
- Confusion
- BP can be abnormal – low if there is shock
Investigations –
- Measuring urine output
- Increase in blood creatinine levels, blood urea nitrogen
- Electrolyte (sodium, potassium, calcium, phosphorus, magnesium) levels may be abnormal
- Blood acid levels may alter, most frequently causing acidosis
- Ultrasound kidney will show any structural abnormalities of the kidneys, presence of any stones, enlarged prostate
Treatment –
- Treatment for AKI usually requires you to stay in a hospital.
- Evaluation and correction of underlying cause should be done.
- Correction of underlying fluid and electrolyte Balance to be done.
- Dialysis which is usually temporary in such instances may be needed to help replace kidney function until your kidneys recover.
Complications -
- After having AKI, your chances are higher for future kidney ailments.
- Electrolyte abnormalities and acidosis may cause altered heart function leading to death
- However, timely intervention may revert the kidney function to normal.