What is Acute Kidney Injury?
A temporary impairment in kidney functions is called Acute Kidney Injury, previously known as acute renal failure. Acute Kidney Injury (AKI) develops over days, often in response to other medical conditions, and it is segregated into 3 main categories based on the injury and where it occurred.
1. Pre-renal : It's caused due to reduced blood flow to kidneys.
2. Intrinsic : It's caused when there’s intrinsic damage to kidneys .
3. Post-renal : It's caused by a blockage in the urinary tract which prevents the flow of urine.
AKI is a serious problem, an early diagnosis and treatment is important for better outcomes and which helps in preventing irreversible kidney damage.
Acute Kidney Injury Causes
Several factors lead in developing AKI, identifying those causes is key to finalize the better treatment options. There are 3 categories which typically causes AKI:
1. Pre-renal Causes: It occurs when blood flow to kidneys is being reduced. Specific conditions like blood loss, severe dehydration due to diarrhea or vomiting, severe infections and heart failure can cause this.
2. Intrinsic Causes:It involves direct damage to kidney tissue itself. Certain medications, infections, toxins, allergic reaction to medications, radiologic contrast can cause this
3. Post-renal Causes:It is caused due to obstruction of the urinary tract, caused by kidney stones, tumors, or enlarged prostate.
Acute Kidney Injury and its Symptoms
The symptoms of AKI can be different depending on the severity of injury and its causes. Some people may be asymptomatic or may experience mild symptoms, while others experience life-threatening complications. AKI symptoms include :
● Decreased urine output
● Swelling in the legs, ankles, or feet
● Fatigue and weakness
● Shortness of breath
● Nausea and vomiting
● Confusion or disorientation
● Chest pain or pressure
● Asymptomatic abnormality in renal function tests/ urine tests
These symptoms can develop rapidly, and prompt medical evaluation is essential if AKI is suspected, especially after a major illness, injury, or surgery.
Diagnosis of Acute Kidney Injury
Diagnosing AKI typically involves a combination of blood tests, urine tests, and imaging studies. The goal is to assess kidney function, identify the underlying cause of the injury, and determine the severity. Common diagnostic tests include:
● Blood tests: Measuring blood levels of creatinine and blood urea nitrogen (BUN) helps evaluate kidney function. Elevated levels of these substances indicate impaired kidney filtration.
● Urine tests: Analyzing urine output and composition can help identify the cause of AKI and assess the extent of kidney damage.
● Imaging tests: Ultrasound, CT scans, or MRI may be used to detect blockages, swelling, or other abnormalities in the kidneys or urinary tract.
Treatment Options for Acute Kidney Injury
The treatment of AKI depends on the underlying cause and the severity of the condition. The primary goals of treatment are to restore normal kidney function, manage symptoms, and prevent complications. Treatment options include:
1. Fluid Management:
○ Intravenous (IV) fluids: If dehydration or blood loss is causing AKI, IV fluids can help restore kidney function.
○ Diuretics: In cases of fluid retention, diuretics may be prescribed to help the body eliminate excess fluids.
2. Medication Adjustments:
○ Medication review: Certain medications that contribute to kidney damage may need to be adjusted or discontinued. Your doctor will review your medications and may prescribe alternatives.
○ Antibiotics: If an infection is causing AKI, antibiotics will be administered to treat the underlying infection.
3. Dialysis:
○ In severe cases of AKI, where the kidneys are unable to filter waste, dialysis may be required. Dialysis temporarily performs the kidneys' function by removing toxins and excess fluids from the blood.
4. Treating the Underlying Cause:
○ Addressing the root cause of AKI is essential for recovery. For instance, treating heart failure, managing blood pressure, or removing a urinary tract obstruction can help restore normal kidney function.
5. Nutritional Support:
○ Dietary changes may be necessary to reduce the workload on the kidneys. A low-sodium, low-potassium, and low-phosphorus diet may be recommended, along with adjustments in fluid intake.
Preventing Acute Kidney Injury
While not all cases of AKI can be prevented, certain steps can reduce your risk:
● Stay hydrated: Drinking enough water is essential for kidney health, especially during illness, intense physical activity, or hot weather.
● Monitor medications: Be cautious with medications that can affect kidney function, and always follow your doctor’s instructions. Avoid self-medication and abusing over-the-counter painkillers.
● Manage chronic conditions: If you have conditions like diabetes, high blood pressure, or heart disease, work closely with your healthcare provider to keep them under control.
● Avoid unnecessary use of contrast dyes: If you need imaging tests with contrast dye, discuss alternatives with your doctor to minimize the risk of kidney damage.
