Acute Kidney Injury

Introduction

Acute Kidney Injury (AKI), sometimes called acute renal failure, is a sudden loss of kidney function that happens over hours or days. AKI makes it hard for your kidneys to filter waste and balance fluids in your body. It is serious but often reversible if treated early ¹

What Causes AKI?

AKI typically occurs due to three main problems:

• 1. Reduced blood flow to kidneys: Caused by severe dehydration, blood loss, heart problems, or infections (like sepsis) . ²
• 2. Direct damage to kidneys: Triggered by infections, inflammation, or harmful substances like certain antibiotics, painkillers (e.g., NSAIDs like ibuprofen), or contrast dye used in imaging tests . ³
• 3. Blocked urine flow: Enlarged prostate, kidney stones, or tumors blocking urine drainage . ⁴

Recognizing the Symptoms ^{5 6}

Many people with AKI experience:

• Urine changes: Producing little/no urine or dark-colored urine.
• Swelling in legs, ankles, or face due to fluid retention.
• Fatigue, confusion, or shortness of breath.
• Nausea, loss of appetite, or chest pain.

Treatment Options ^{7 8 9}

Treatment focuses on the cause:

• Fluids: Given intravenously (IV) for dehydration.
• Medication adjustments: Stopping harmful drugs or treating infections.
• Dialysis: Temporarily filters blood if kidneys are severely damaged (needed in 5–10% of cases).
• Antibiotics: for infections ⁵
• Diet changes: Limiting salt, potassium, and protein to ease kidney workload.

Prevention Tips ¹⁰

Reduce your risk by:

• 1. Staying hydrated (drink water unless your doctor advises otherwise).
• 2. Using painkillers (e.g., NSAIDs) only as directed.
• 3. Managing chronic conditions like diabetes or high blood pressure ¹¹
• 4. Alerting doctors about kidney issues before CT scans using contrast dye.

Recovery and Long-Term Outlook ^{11 12}

• Most people recover fully if treated early.
• Some may develop chronic kidney disease (CKD) or need ongoing monitoring.
• Follow up with your doctor to check kidney health after AKI.

When to Seek Help

Contact your healthcare provider if you:

• Urinate significantly less
• Have unexplained swelling or extreme fatigue
• Experience confusion or trouble breathing

Key Takeaways

• AKI is a sudden drop in kidney function.
• Causes include dehydration, medications, or blockages.
• Early treatment often leads to full recovery.
• Stay informed and partner with your care team for the best outcomes.

References

1. 1. Kidney Disease: Improving Global Outcomes (KDIGO). KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney Int Suppl. 2012;2(1):1–141.
2. 2. Mehta RL, et al. Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care. 2007;11(2):R31.
3. 3. Perazella MA. Drug-induced acute kidney injury. Curr Opin Crit Care. 2019;25(6):550–557.
4. 4. Khwaja A. KDIGO Clinical Practice Guidelines for Acute Kidney Injury. Nephron Clin Pract. 2012;120(4):c179–c184.
5. 5. Acute Kidney Injury - Symptoms, causes, treatment. National Kidney Foundation. 2025
6. 6. KDIGO Clinical Practice Guideline for Acute Kidney Injury. 2012
7. 7. Prowle JR, et al. Fluid management for the prevention and attenuation of acute kidney injury. Nat Rev Nephrol. 2014;10(1):37–47.
8. 8. Uchino S, et al. Acute renal failure in critically ill patients. JAMA. 2005;294(7):813–818.
9. 9. Fiaccadori E, et al. Nutritional support in acute kidney injury. J Nephrol. 2008;21(5):645–656.
10. 10. James MT, et al. Risk factors for acute kidney injury in older adults. Clin J Am Soc Nephrol. 2016;11(7):1192–1200.
11. 11. Coca SG, et al. Long-term risk of mortality and other adverse outcomes after acute kidney injury. Kidney Int. 2009;76(4):422–427.
12. 12. Chawla LS, et al. Acute kidney injury and chronic kidney disease as interconnected syndromes. N Engl J Med. 2014;371(1):58–66.