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Acute Kidney Injury (AKI)

Overview

AKI or acute kidney injury is a sudden and often reversible decline in renal function over a short period of time. If identified and treated promptly, kidney function can frequently be restored. AKI can result from acute dehydration such as in cases of severe diarrhoea or burns, secondary sepsis, certain medications, or following surgical procedure.

The underlying causes of AKI can be classified as follows:

  • Pre-Renal AKI: Pre-renal AKI is caused by reduced blood flow to the kidneys due to dehydration, low blood pressure, or heart failure.
  • Intrinsic Renal AKI: Results from direct damage to the kidney tissue, such as infections, toxins, or autoimmune diseases.
  • Post renal AKI: Occurs due to the obstruction in the urinary tract, such as from kidney stones, tumours, or an enlarged prostate.

The presentation of AKI can vary:

Mild cases may be asymptomatic and identified only during laboratory investigations.

Severe cases of AKIs may present with:

  • reduced urine output
  • swelling in the face and feet
  • reddish discoloration of urine
  • Aabdominal pain

A kidney specialist (nephrologist) should be consulted for the diagnosis and management of AKI.

Accurate diagnosis of AKI involves:

  • Urine tests
  • Blood tests to assess renal function
  • Imaging studies, such as an ultrasound, to confirm normal kidney size and identify potential structural abnormalities.

The management of AKI is tailored to address the underlying cause, including:

  • Rehydration therapy for patients suffering from diarrhoea or burns,
  • Antibiotic therapy for treating sepsis
  • Discontinuation of nephrotoxic medications, i.e. drugs that cause AKI.
  • In some severe cases, advanced interventions such as immunosuppressive therapy or temporary dialysis may be necessary to support kidney function until recovery.
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