Acute kidney injury
Overview
Acute kidney injury (AKI) is where your kidneys suddenly stop working properly. It can range from minor loss of kidney function to complete kidney failure.
Symptoms
Symptoms of AKI include: feeling sick or being sickdiarrhoeadehydrationpeeing less than usualconfusiondrowsiness Even if it does not progress to complete kidney failure, AKI needs to be taken seriously. It has an effect on the whole body, changes how some medicines are handled by the body, and could make some existing illnesses more serious. AKI is different fromchronic kidney disease, where the kidneys gradually lose function over a long period of time.
Causes
Most cases of AKI are caused by reduced blood flow to the kidneys, usually in someone who's already unwell with another health condition. This reduced blood flow could be caused by: low blood volume after bleeding, excessive vomiting or diarrhoea, or severedehydrationthe heart pumping out less blood than normal as a result ofheart failure, liver failure orsepsiscertain medicines that reduce blood pressure or blood flow to the kidneys, such as ACE inhibitors, certain diuretics or NSAIDs AKI can also be caused by a problem with the kidney itself, such as inflammation of the filters in the kidney (glomerulonephritis), the blood vessels (vasculitis), or other structures in the kidney. This may be caused by a reaction to some medicines, infections or the liquid dye used in some types of X-rays. It may sometimes be the result of a blockage affecting the drainage of the kidneys, such as: anenlarged prostatea tumour in the pelvis, such as an ovarian or bladder tumourkidney stones Urine can be tested for protein, blood cells, sugar and waste products, which may give clues to the underlying cause. Doctors also need to know about: any other symptoms, such as signs ofsepsisorsigns of heart failureany other medical conditionsany medicine that's been taken in the past week, as some medicines can cause AKI Anultrasound scanshould reveal if the cause is a blockage in the urinary system, such as an enlarged prostate or bladder tumour.
Prevention
Those at risk of AKI should be monitored with regular blood tests if they become unwell or start new medicine. It's also useful to check how much pee you're passing. Any warning signs of AKI, such as vomiting or producing little pee, require immediate investigation for AKI and treatment. People who are dehydrated or at risk of dehydration may need to be given fluids through a drip. Any medicine that seems to be making the problem worse or directly damaging the kidneys needs to be stopped, at least temporarily.