Acute Kidney Injury (AKI)

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What is Acute Kidney Injury (AKI)?

Acute Kidney Injury (AKI), previously known as acute renal failure, is a sudden and rapid decline in kidney function. The kidneys lose their ability to filter waste products, balance fluids, and maintain electrolyte levels in the body. This condition develops over hours or days and can range from mild dysfunction to complete kidney failure. AKI is a medical emergency that requires immediate attention.

Symptoms and Causes

Symptoms:

The symptoms of AKI can vary depending on its severity and underlying cause but may include:

  • Decreased urine output or no urine production
  • Swelling in legs, ankles, or around the eyes due to fluid retention
  • Fatigue and weakness
  • Shortness of breath
  • Nausea and vomiting
  • Confusion or difficulty concentrating
  • Chest pain or pressure
  • Seizures or coma (in severe cases)

Causes:

AKI can occur due to several factors, broadly categorized into three groups:

Pre-renal Causes (Reduced blood flow to the kidneys):

  • Severe dehydration
  • Blood loss or low blood pressure
  • Heart failure or heart attack
  • Sepsis

Intrinsic Causes (Damage to kidney tissue):

  • Acute tubular necrosis (ATN)
  • Glomerulonephritis (inflammation of kidney filters)
  • Acute interstitial nephritis (allergic reaction or infection)
  • Toxins or medications (e.g., nonsteroidal anti-inflammatory drugs, certain antibiotics, or contrast dyes used in imaging)

Post-renal Causes (Obstruction of urine flow):

  • Kidney stones
  • Enlarged prostate
  • Tumors or injuries that block urinary drainage

Diagnosis and Tests

Diagnosing AKI involves identifying the cause and assessing the extent of kidney damage through various tests and evaluations:

Medical History and Physical Examination:

  • Review of symptoms, medical history, and recent medication use.
  • Examination for signs of dehydration, swelling, or infections.

Laboratory Tests:

Blood tests:

  • Elevated levels of creatinine and blood urea nitrogen (BUN).
  • Electrolyte imbalances (e.g., high potassium levels).

Urinalysis:

  • Detection of protein, blood, or abnormal cells in urine.

Imaging Tests:

  • Ultrasound or CT scans to detect obstructions or structural abnormalities in the kidneys.

Kidney Biopsy (in selected cases):

  • A small tissue sample may be taken to identify specific types of kidney damage.

Complications of AKI

If not treated promptly, AKI can lead to severe complications, including:

  • Chronic kidney disease (CKD) or permanent kidney damage
  • Electrolyte imbalances (e.g., hyperkalemia, which can cause heart arrhythmias)
  • Fluid overload leading to pulmonary edema
  • Increased risk of infections
  • Multiorgan failure

Conclusion

Acute Kidney Injury is a serious condition that requires immediate medical attention. Early diagnosis and timely treatment can significantly improve outcomes and minimize the risk of complications. If you experience symptoms of AKI or have underlying conditions that increase your risk, consult a healthcare provider promptly.

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