Acute Kidney Injury (AKI)
Acute Kidney Injury (AKI), previously known as acute renal failure, is a sudden episode of kidney failure or kidney damage that happens within a few hours or days. It causes a buildup of waste products in the blood and makes it hard for the kidneys to maintain the right balance of fluid in the body. AKI can affect other organs such as the brain, heart, and lungs.
Illness and Conditions
AKI is a serious condition that requires immediate medical attention. It often occurs in hospitalised patients, especially those who are critically ill or have other underlying health problems. The severity of AKI ranges from minor loss of kidney function to complete kidney failure. In some cases, AKI can resolve completely, while in others it can lead to chronic kidney disease or end-stage renal disease.
Symptoms
Symptoms of AKI may develop rapidly and can include:
- Decreased urine output, although occasionally urine output remains normal
- Swelling in legs, ankles, and around the eyes due to fluid retention
- Fatigue and weakness
- Shortness of breath
- Confusion or difficulty concentrating
- Nausea
- Chest pain or pressure in severe cases
Causes
AKI can be caused by a variety of factors, often categorised into three groups:
- Pre-renal causes: Conditions that reduce blood flow to the kidneys, such as dehydration, heart failure, severe infection (sepsis), or blood loss.
- Intrinsic causes: Direct damage to the kidneys due to inflammation, toxins, infections, or autoimmune diseases.
- Post-renal causes: Obstruction of urine flow due to kidney stones, tumours, or an enlarged prostate.
Diagnosis
Diagnosis of AKI involves:
- Medical history and physical examination
- Blood tests to measure kidney function, including serum creatinine and blood urea nitrogen (BUN)
- Urine tests to check for abnormalities
- Imaging studies such as ultrasound to identify obstructions or structural problems
- In some cases, a kidney biopsy may be necessary to determine the exact cause
Treatment
Treatment of AKI depends on the underlying cause and the severity of the condition:
- Addressing the root cause, such as treating infections or removing obstructions
- Managing fluid balance carefully to avoid overload or dehydration
- Medications to control symptoms and prevent complications
- Temporary dialysis may be required if kidney function is severely impaired
- Close monitoring in a hospital setting is often necessary
Prevention
Preventing AKI involves:
- Staying well hydrated, especially during illness or heat exposure
- Avoid medications that can harm the kidneys unless prescribed by a doctor
- Promptly treating infections and other medical conditions
- Managing chronic diseases such as diabetes and high blood pressure effectively
- Regular monitoring of kidney function in high-risk individuals
Early recognition and treatment of Acute Kidney Injury are essential to prevent permanent kidney damage and improve outcomes. If you experience symptoms suggestive of AKI, seek medical attention promptly.