Acute Kidney Injury: Causes, Symptoms, Treatment and Prevention

The prevalence of acute kidney injury (AKI), globally is on the rise. According to the World Health Organization (WHO), close to 1.7 million people worldwide die annually from AKI. About 1 percent of patients admitted to hospitals have AKI at the time of admission, says Medscape.  Furthermore, the estimated incidence of AKI during hospitalization increases to 2-5 percent. As stated by mdedge, “AKI management in the non-intensive care setting incurs the third-highest median direct hospital cost after acute Myocardial Infarction and Stroke”.

Acute Kidney Injury – also called acute kidney failure or acute renal failure occurs when your kidney suddenly stop functioning for two days or less. AKI incidents can be fatal and require serious treatment. AKI, unlike kidney failure, can be reversible if detected and treated with dispatch. If you are in good health before having an AKI, your kidney functions may be totally or nearly restored after an AKI treatment.   

Must Read: What are the Causes of Kidney Problem?

Symptoms

The symptoms and signs of acute kidney failure vary from person to person. These may include:

  • Lowered urine output, though at times urine output stays normal
  • Swelling in your feet, legs, or ankles due to fluid retention.
  • Shortness of breath
  • Tiredness
  • Nausea
  • Confusion
  • Weakness
  • Irregular heartbeat
  • Pressure or pain in your chest.
  • Diarrhea
  • Coma or seizures in severe cases

Occasionally, acute kidney failure causes no symptoms or signs.

Causes of Acute Kidney Injury

Many things can cause acute kidney failure, some of these include:

  • When you have an illness that impedes blood flow to your kidneys
  • When you have a direct injury to your kidneys
  • When your ureters become blocked and you can’t pass out wastes out of your body through  your urine

Weakened blood flow to the kidneys

Diseases and conditions that may inhibit blood flow to your kidneys and result in kidney injury include:

  • Heart attack
  • Infection
  • Blood or fluid loss
  • Severe burns
  • Blood pressure medications
  • Severe dehydration
  • Liver failure
  • Severe allergic reaction
  • Heart disease
  • Use of NSAID drugs that include ibuprofen, naproxen sodium (Aleve, others), aspirin or related drugs

Impairment of the kidneys

Several diseases, agents, and conditions may impair the kidneys and result in acute kidney failure. These include:

  • Blood clots in the arteries or veins in and around the kidneys.
  • Cholesterol deposits that hinder blood passage in the kidneys.
  • Glomerulonephritis, that is swelling of the tiny filters in the kidneys (glomeruli)
  • Infection
  • Hemolytic uremic syndrome, a condition caused by early destruction of red blood cells
  • Lupus, an immune system disease that causes Glomerulonephritis.
  • Medications, that include some chemotherapy drugs, dyes, and antibiotics used in imaging tests
  • Scleroderma – rare diseases that affects connective tissues and skin.
  • Thrombotic thrombocytopenic purpura – an uncommon blood disease.
  • Toxins, including alcohol, cocaine, and heavy metals.
  • Rhabdomyolysis (muscle tissue breakdown) that results in kidney damage as a result of  toxins from muscle tissue destruction
  • Tumor lysis syndrome – the breakdown of tumor cells that causes the release of toxins that can lead to kidney injury

Blockage of urine in the kidneys

Diseases and conditions that obstruct the flow of urine out of your body (urinary obstructions) and can cause acute kidney injury include:

  • Prostate cancer
  • Blood clots in the urinary tract
  • Colon cancer
  • Cervical cancer
  • Kidney stones
  • Enlarged prostate
  • Nerve damage that involves the nerves that oversee the bladder
  • Bladder cancer

Risk Factors

Acute kidney failure most times occurs in connection with other medical conditions or events. Several conditions, including the following, can increase your risk of developing acute kidney injury:

  • Being hospitalized, particularly for  serious conditions that need intensive care
  • Advanced age – 65 years and over
  • Blockages in the blood vessels, especially in the legs or arms (peripheral artery disease)
  • Heart failure
  • Liver diseases
  • Diabetes
  • Kidney diseases
  • High blood disease
  • Specific cancers and their treatments

Complications

Potential complications that could result from acute kidney failure include:

  • Fluid buildup: AKI could further lead to a build-up of fluids in your lungs that could cause shortness of breath.
  • Muscle weakness: This occurs when your body’s electrolytes and fluids are askew, muscle weakness can result.
  • Chest pain: You may experience chest pain if your pericardium (the lining over the heart) gets weakened.
  • Permanent kidney damage: Sometimes, acute kidney failure results in lifelong loss of kidney function or end-stage renal disease. People with permanent kidney failure need a kidney transplant or permanent dialysis to live.
  • Death. Acute kidney failure can result in total loss of kidney function and ultimately, death.

Diagnosing Acute Kidney Injury

Your doctor may suspect acute kidney injury if you are:

  • At high risk and you suddenly fall sick
  • Have symptoms of AKI

Doctors, most times diagnosed AKI with a blood test by measuring the levels of creatinine- (a waste product produced by the muscles). The presence of high levels of creatinine indicates that your kidneys are not functioning optimally. Other tests that can confirm AKI include:

Urine test: You may be requested to provide a pee sample for testing. This will reveal any abnormalities in the kidney.

Imaging tests: This includes the use of an ultrasound scan or computed tomography that allows physicians to inspect your kidneys for any abnormalities.

Kidney biopsy: Your doctor might decide to conduct a kidney biopsy. This involves the removal of a small sample of your kidney tissue through a needle via your skin for laboratory testing.

Prevention of Acute Kidney Injury

AKI prevention is hard due to the nature of how it occurs. That said, taking good care of your kidney can minimize your risk of developing AKI, chronic kidney disease, and kidney failure.

The following guides can help you keep your kidney as healthy as possible.

  • Work with your physician to manage diabetes, high blood pressure and other chronic conditions.
  • Make living a healthy lifestyle a priority: Get active, consume diets low in fat and salts, and cut your alcohol consumption.
  • Pay attention to how you take over-the-counter drugs: Taking too many over-the-counter drugs such as aspirin, ibuprofen, acetaminophen, and other naproxen sodium can increase your risk of developing acute kidney injury. You shouldn’t take more than the dosage recommended on the package.

Treatment for Acute Kidney Injury

AKI treatment in most cases would need that you stay in the hospital. How long you will stay depends on what causes the injury and how quickly your kidney functions get restored. Besides treating you for what led to the AKI problem, you may get other treatments for things that could make it harder for your kidneys to recover. Some likely treatments include:

  • Medications to regulate the amounts of minerals and vitamins in your blood.
  • Treatment to balance the correct amount of fluids in your blood.
  • Temporary hemodialysis to remove toxins from your blood until your kidneys recovers.

Acute Kidney Injury, based on current research, can’t be prevented, but making healthy lifestyle choices that include moderate use of over-the-counter drugs, getting active, limiting your intake of alcohol, and going for a checkup can lower your risk of developing this disease.

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