Acute Kidney Injury

What is Acute Kidney Injury?

Acute renal failure (ARF), also known as acute kidney injury (AKI), is a sudden decline in kidney function. Unlike chronic kidney disease, ARF develops rapidly, often within hours or days. The good news is that with prompt diagnosis and treatment, the kidneys can often recover completely.

Symptoms

AKI may present with new onset of leg swelling, swelling around the eyes, reduction in urine output, and high blood pressure. With specific causes of AKI, patients may have severe back pain, as may occur with an obstructive kidney stone or kidney infection. Certain autoimmune conditions can present with joint pains, rash, and fatigue.

Causes

There are multiple possible causes of AKI:

• Severe dehydration: for example, from nausea/vomiting/diarrhea; excessive fluid removal with the use of diuretic medications.
• Severe infections resulting in sepsis.
• Use of kidney-toxic medications, such as NSAID (Non-Steroidal Anti-inflammatory Drugs) painkillers, contrast dyes used for CT scans, or certain antibiotics.
• Obstruction of the urinary tract – from kidney stones or an enlarged prostate.
• Dysfunction of other organ systems – for example, liver failure and heart failure can result in kidney injury.
• Glomerulonephritis – inflammation of the kidneys which can be reversed if diagnosed early.

Treatment

Treatment of the underlying cause of AKI usually results in improvement in kidney function. Usually, kidney function can completely recover to the patient’s prior level of function. However, in the case of severe AKI, recovery can be incomplete, and the patient may be left with Chronic Kidney Disease (CKD).

Treatment often will require management of electrolytes, fluid, and acid-base imbalances that may occur with the AKI state. This may involve the use of IV fluids, certain medications, and in severe cases, temporary dialysis may be needed.