What is acute kidney injury (AKI)?
When kidney failure sets in a matter of a few hours or few days. Acute kidney injury is the point at which the kidneys all of a sudden quit working. Typically, the kidneys filter the blood and remove waste and water and maintain elements. “Acute” signifies a sudden or temporary or short period of time. In the case of an AKI nephrologist needs to be consulted as early as possible. Acute kidney injury is also known as Acute Kidney Failure or Acute Renal Failure.
What causes acute kidney injury?
Acute kidney injury can have various causes. It can happen when:
- Less blood blood circulation to kidneys as in heart failure, shock, and other critical illnesses mostly in icu patients.
- The kidneys get damaged. A few reasons for kidney damage are cancer, infections, certain medicines, and some autoimmune conditions.
- Urine outflow tract is blocked. A few reasons for blockages are prostate issues (in men) and cancer. The blockage of urine causes pressure on the kidney, which prompts damage.
What are the symptoms of severe kidney injury? A few people don’t have any symptoms from the start. People who are in the hospital may discover that they have intense kidney damage after they have blood tests for another explanation.
At the point when people do have symptoms, the symptoms can include:
- Less or no urine output
- Blood in the urine
- Swelling, particularly in the feet or face
- Vomiting, or not feeling hungry
- Feeling weak, or getting tired effectively
- Altered senses
- Seizures – Seizures are rushes of anomalous electrical activity in the brain. They can make people drop, or move or carry on abnormally.
Is there a test for acute kidney injury?
The Nephrologist will get some information about your symptoms and do an exam. To make sure how fine your kidneys are working, a nephrologist will do urine and blood tests. Main tests are blood urea, creatinine, electrolytes, urine analysis and ultrasound of the abdomen.
The vast majority will have an imaging test called an ultrasound to search for blockages in the urinary tract. Your kidney doctor may do different tests to search for different reasons for your intense kidney injury. Other tests like vasculitic markers, computed tomography and others.
If these tests don’t show what’s causing your intense kidney injury, your nephrologist may do a test called a kidney biopsy. For a kidney biopsy, the nephrologist will place a needle into your back and into your kidney. A Nephropathologist will look at the sample under a microscope.
How is acute kidney injury treated?
Treatment relies upon what’s causing your intense kidney injury and how serious the kidney injury is.
If AKI is because of medicine, a nephrologist will ask you to quit taking that medicine. In addition, to enable your kidneys to heal, the kidney doctor will give you medicines called steroids which might help in managing drug induced AKI or drug induced acute interstitial nephritis.
In the event that your acute kidney injury has another reason that can be treated, your nephrologist will treat it. For example, kidney doctors can treat infections with antibiotics.
Some cases if AKI is secondary to some acute illness then after managing acute illness there will be spontaneous recovery of AKI.
Until your kidneys can work normally once more, you may require treatments to help ensure your body has the perfect measure of salt, fluid, and nutrients. Also control of excess toxins like urea, creatinine, potassium, phosphorus and others. These treatments can include:
- Changes in your diet
- Renal substitution therapy – This treatment assumes control over the job of your kidneys until they can heal. It includes either:
- Hemodialysis – Hemodialysis is a strategy where a machine assumes control over the job of the kidneys. The machine siphons blood out of the body, filters it, and returns it to the body. Frequency and duration might differ from cases of chronic kidney disease. In AKI patients may require daily or alternate days depending upon severity and extent of AKI.
- Peritoneal dialysis – Peritoneal dialysis is a system that individuals do at home each day. It includes channeling a unique fluid into the belly. This fluid gathers waste and excess salt and water from the blood. At that point the pre-owned fluid drains out of the belly. In AKI generally peritoneal dialysis is not preferred as it can’t be started instantly. To begin this peritoneal dialysis catheter needs to be placed at least 7 days before starting dialysis. In AKI many times the decision of doing dialysis is sudden, there is no time to wait.
Finally AKI is an emergency condition. It needs to be detected at an early stage, as it is difficult to manage at a later stage of AKI. As soon as it is diagnosed, it needs to be referred to a nephrologist. Nephrologists will find out the cause, severity, further management and whether renal replacement therapy is required or not.