Acute kidney injury

Diagnosis

When should AKI be suspected?

A doctor may suspect AKI in people known to be at risk who suddenly fall ill or develop symptoms which suggest complications of AKI.

AKI may also be suspected in people who have been unwell for a while and have either:

chronic kidney disease
a urinary system disease
new or worsening urinary symptoms
symptoms or signs of a disease affecting the kidneys and other organs

Diagnosing acute kidney injury

AKI can be diagnosed after measuring urine output and doing blood tests.

Blood levels of creatinine a chemical waste product produced by the muscles will be measured. Healthy kidneys filter creatinine and other waste products from the blood and these are excreted, in the form of urine.
It's an easy and quick marker of kidney function, with higher levels of creatinine in the bloodindicating poorer kidney function.

In adults, a diagnosis of AKI can be made if:

blood creatinine level has risen from the baseline value for that person (by 26 micromoles per litre or more within 48 hours)
blood creatinine level has risen over time (by 50% or more within the past 7 days)
they are passing much less urine (less than 0.5ml per kg per hour for more than 6 hours)

In children and teenagers, doctors should use the plasma creatinine level to calculate the estimated glomerular filtration rate ( estimated glomerular filtration rate (eGFR). A diagnosis of AKI is made if they have a 25% or greater fall in eGFR within the past 7 days.

They may:

advise stopping any medication that may becausing the situation, or making it worse it may be safe to resume some of these when the problem is sorted
treat any underlying infections
advise on fluid intake to prevent dehydration (which could cause or worsen AKI)
take blood tests to monitor levels of creatinine and salt to check how well a person is recovering
refer to a urologist (genitourinary surgeon) or nephrologist (kidney specialist) if the cause isn't clear or if a more serious cause is suspected

Admission to hospital

Admission to hospital is necessary in cases where:

there's an underlying cause that needs urgent treatment such as a urinary blockage, or if the person is seriously unwell; most people need hospital care to treat the underlying cause, allowing the AKI to get better
there's a risk of urinary blockage because of prostate disease, for example:

the person's condition has deteriorated , and regular blood and urine tests are needed to monitor how well their kidneys are working
the person has a complication of AKI

The majority of people who recover from AKI end up with a very similar level of kidney function as they had before they became ill, or go on to have normal kidney function.

However, some people go on to develop chronic kidney disease or long-term kidney failure as a result. In severe cases, dialysis where a machine filters the blood to rid the body of harmful waste, extra salt and water may be needed.

Medically Reviewed by a doctor on 30 Nov 2016

Articles for acute kidney injury

Symptoms

In the early stages of AKI, there may not be any symptoms.The only possible warning sign may be that the person isn't producing much urine, although this isn't always the case.

Causes

Most cases of AKI are caused by reduced blood flow to the kidneys, usually in someone who is already unwell with another health condition.

Diagnosis

AKI can be diagnosed after measuring urine output and doing blood tests. Blood levels of creatinine a chemical waste product produced by the muscles will be measured. Healthy kidneys filter creatinine and other waste products from the blood and these are excreted, in the form of urine.

Treatment

Treatment of AKI depends on the underlying cause and extent of illness. In most cases, treating the underlying problem will cure the AKI. GPs may be able to manage mild cases in people who aren't already in hospital.

Prevention

Those at risk of AKI should be monitored with regular blood tests if they become unwell or start new medication. It's also useful to check how much urine you're passing.

Complications

Complications of an acute kidney injury need to be dealt with immediately in a hospital setting under rigorous medical supervision. Some of the complications are high levels of potassium in the blood, fluid in the lungs, etc.

Introduction

Acute kidney injury (AKI) is sudden damage to the kidneys that causes them to not work properly. It can range from minor loss of kidney function to complete kidney failure.

Health News