Acute Kidney Injury

Acute kidney injury (AKI) is a sudden loss of kidney function that occurs over a short period, typically within hours to days. It is also known as acute renal failure. AKI can be caused by a variety of factors, including decreased blood flow to the kidneys, direct damage to the kidneys, and obstruction of urine flow.

Causes

AKI can be caused by:

• Decreased blood flow to the kidneys (ischemia), which can occur due to:
  • Dehydration
  • Blood loss
  • Shock
  • Heart failure
• Direct damage to the kidneys, which can occur due to:
  • Toxins, such as certain medications (e.g., NSAIDs, aminoglycosides) or substances (e.g., heavy metals)
  • Infections (e.g., sepsis, pyelonephritis)
  • Autoimmune disorders (e.g., vasculitis)
• Obstruction of urine flow, which can occur due to:
  • Kidney stones
  • Tumors
  • Blood clots

Symptoms

The symptoms of AKI may include:

• Decreased urine output (oliguria)
• Swelling (edema) in the legs, ankles, and feet
• Fatigue
• Nausea and vomiting
• Abdominal pain
• Shortness of breath

Diagnosis

AKI is typically diagnosed using a combination of:

• Medical history and physical examination
• Laboratory tests, including:
  • Serum creatinine levels
  • Blood urea nitrogen (BUN) levels
  • Electrolyte panels
• Imaging studies, such as:
  • Ultrasound
  • Computed tomography (CT) scan
  • Magnetic resonance imaging (MRI)

Treatment

The treatment of AKI depends on the underlying cause and may include:

• Fluid replacement to correct dehydration and electrolyte imbalances
• Medications to manage symptoms, such as:
  • Diuretics to increase urine output
  • Antibiotics to treat infections
• Dialysis or other renal replacement therapies to support kidney function
• Surgical intervention to relieve obstruction or repair damaged kidneys

Complications

AKI can lead to several complications, including:

• Chronic kidney disease (CKD)
• End-stage renal disease (ESRD)
• Cardiovascular disease
• Infections
• Mortality

Prevention

To prevent AKI, it is essential to:

• Stay hydrated by drinking plenty of fluids
• Avoid medications that can harm the kidneys
• Manage underlying medical conditions, such as diabetes and hypertension
• Avoid exposure to toxins and heavy metals