Summary about Disease
Acute Kidney Injury (AKI), formerly known as acute renal failure, is a sudden decrease in kidney function that occurs over a short period of time (hours to days). This leads to a buildup of waste products in the blood and makes it difficult for the kidneys to maintain fluid and electrolyte balance. AKI can range in severity from mild kidney dysfunction to complete kidney failure. It is often reversible if detected and treated promptly.
Symptoms
Symptoms of AKI can vary depending on the severity and underlying cause. Common symptoms include:
Decreased urine output, although occasionally urine output remains normal
Fluid retention, causing swelling in your legs, ankles or feet
Shortness of breath
Fatigue
Confusion
Nausea
Weakness
Irregular heartbeat
Chest pain or pressure
Seizures or coma in severe cases
Causes
AKI can be caused by a variety of factors, which are generally categorized into three main groups:
Prerenal: Reduced blood flow to the kidneys, which can be caused by dehydration, blood loss, heart failure, liver failure, severe infections (sepsis), or certain medications (e.g., NSAIDs, ACE inhibitors).
Intrarenal: Direct damage to the kidneys themselves, caused by glomerulonephritis, acute tubular necrosis (ATN) from ischemia or toxins, infections, certain medications (e.g., aminoglycoside antibiotics, radiocontrast dye), or autoimmune diseases.
Postrenal: Obstruction of urine flow, caused by kidney stones, tumors, enlarged prostate, or blood clots in the urinary tract.
Medicine Used
Treatment depends on the underlying cause and severity of AKI. There are no medications that specifically cure AKI but medications are used to manage the complications of AKI. Common medicines that are used are:
Diuretics: To remove excess fluid from the body.
Medications to control blood potassium: To prevent dangerous high potassium levels (hyperkalemia).
Medications to control blood pressure: To manage hypertension, which can worsen kidney damage.
Calcium supplementation: May be needed to correct imbalances in calcium levels.
Phosphate binders: May be needed to control phosphate levels.
In severe cases, dialysis or hemofiltration: To remove waste products and excess fluid from the blood. Note: Medication depends on the underlying cause of the AKI.
Is Communicable
No, Acute Kidney Injury is not communicable. It is not caused by infectious agents and cannot be spread from person to person.
Precautions
Precautions to help reduce the risk of AKI or prevent further kidney damage:
Manage existing health conditions: Control diabetes, high blood pressure, and heart disease.
Avoid medications that can harm the kidneys: Use NSAIDs (nonsteroidal anti-inflammatory drugs) and certain antibiotics cautiously. Always inform your doctor of all medications you are taking.
Stay hydrated: Drink plenty of fluids, especially if you are exercising or in a hot environment.
Avoid toxins and excessive alcohol consumption.
If you are undergoing procedures with contrast dye, discuss kidney protection strategies with your doctor.
Consider diet modification if you have kidney disease.
Avoid smoking.
How long does an outbreak last?
AKI is not an outbreak-related disease, because it is not communicable. AKI refers to a condition in an individual that can last days to weeks. Resolution depends on the underlying cause, severity of the kidney damage, and the individual's overall health. It may be acute and resolve in a few days or weeks, or it may become chronic or even fatal.
How is it diagnosed?
AKI is diagnosed through a combination of:
Blood tests: To measure creatinine and blood urea nitrogen (BUN) levels, which indicate kidney function. Estimated Glomerular Filtration Rate (eGFR) is calculated based on creatinine level.
Urine tests: To analyze urine output, protein levels, and other abnormalities.
Imaging tests: Such as ultrasound or CT scan, to visualize the kidneys and urinary tract and identify any obstructions or structural abnormalities.
Kidney biopsy: In some cases, a kidney biopsy may be necessary to determine the specific cause of the kidney damage.
Timeline of Symptoms
The timeline of AKI symptoms can vary widely. Here's a general progression:
Initial Stage (Hours to Days): Symptoms might be subtle. Decreased urine output may be the first noticeable sign, along with mild fatigue or swelling. Often AKI is detected during routine labs because there are not many symptoms.
Progressive Stage (Days to Weeks): Symptoms become more pronounced. Fluid retention worsens, leading to shortness of breath and swelling. Confusion, nausea, and weakness may develop. Blood tests will show a significant increase in creatinine and BUN.
Severe Stage (Days to Weeks): In severe cases, symptoms can include irregular heartbeat, chest pain, seizures, or coma. Dialysis or hemofiltration may be required.
Important Considerations
AKI is a serious condition that requires prompt medical attention.
Early diagnosis and treatment are crucial for improving outcomes.
AKI can have long-term consequences, including chronic kidney disease (CKD).
Individuals with pre-existing kidney disease, diabetes, heart failure, or high blood pressure are at higher risk for AKI.
Preventive measures, such as staying hydrated and avoiding nephrotoxic medications, can help reduce the risk of AKI.
Close follow-up with a nephrologist is important after AKI to monitor kidney function and prevent recurrence.