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Learn about the causes, symptoms, diagnosis and treatment of AKI, a serious condition where the kidneys suddenly stop working properly. Find out who's at risk, how to prevent it and what complications it can cause.
Learn about the definition, causes, diagnosis, management and prevention of acute kidney injury (AKI), a sudden decline in renal function. Find out the risk factors, complications, prognosis and scenarios of AKI.
- Introduction
- Aetiology
- Risk Factors
- Clinical Features
- Investigations
- Diagnosis
- Management
- Complications
- References
An acute kidney injury (AKI) is caused by a rapid deterioration in kidney function. This is a common, yet serious occurrence in hospitalised patients, with AKI occurring in up to 20% of hospital admissions.1
AKI can occur when there is asudden decrease in glomerular filtration rate (GFR). GFR is maintained by sufficient blood flow into the kidneys, functioning nephrons and a clear pathway for outflow of urine from the kidney. If there are alterations to this system, an AKI can occur. At the glomerular level, GFR is dependent on a pressure gradientbetwe...
Risk factorsfor acute kidney injury include: 1. Chronic kidney disease (adults with an eGFR < 60 ml/min/1.73 m2are at high risk) 2. Heart failure 3. Liver disease 4. Diabetes 5. History of acute kidney injury 6. Oliguria (< 0.5 ml/kg/hour) 7. Neurological or cognitive impairment or disability, which may mean limited access to fluids because of reli...
The timeline of AKI occurs over hours to days. The presenting history will provide clues to the likely cause of the AKI.
AKI is detected biochemically by checking urea and electrolytes. Subsequent investigations are guided by history and examination, but an algorithmic approach will yield baseline information that can guide tailored/specialised testing.
The kidney disease improving global outcomes (KDIGO) classification tool is the most up to date and commonly used.6 The KDIGO systemconfirms an AKI with any of the following present:6 1. Urine output less than 0.5ml/kg/hr for 6 hours 2. Serum creatinine increase 1.5x the baseline over 7 days 3. Serum creatinine increase by 0.3mg/dL in 48 hours Ther...
The mainstay of AKI management isprompt identification and removal of the causative agent(s) while providing supportive treatmentfor the AKI itself.
AKI can be a significant cause ofmorbidity and mortality, especially in patients admitted to Intensive Care. Having poorer pre-morbid status prior to developing the AKI is a significant negative predictor for recovery.9 Recognition and prompt management of an AKI are essential in preventing permanent damage or progression to chronic kidney disease(...
Wang, H. E., Muntner, P., Chertow, G. M., & Warnock, D. G. (2012). Acute kidney injury and mortality in hospitalized patients. American Journal of Nephrology, 35(4), 349–355.Santos, W. J. Q., Zanetta, D. M. T., Pires, A. C., Lobo, S. M. A., Lima, E. Q., & Burdmann, E. A. (2006). Patients with ischaemic, mixed and nephrotoxic acute tubular necrosis in the intensive care...Zhu, K., Song, H., Zhang, Z., Ma, B., Bao, X., Zhang, Q., & Jin, J. (2020). Acute kidney injury in solitary kidney patients after partial nephrectomy: incidence, risk factors and prediction. Transl...Patel, J. B., & Sapra, A. (2021). Nephrotoxic Medications. In StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing LLC. Available from: [LINK]AKI is a sudden drop in kidney function that can be caused by various conditions. Learn about the symptoms, diagnosis, treatment and recovery of AKI from Kidney Care UK, a charity for people with kidney problems.
Sep 17, 2024 · Acute kidney injury (AKI), previously known as acute renal failure (ARF), is an acute decline in kidney function, leading to a rise in serum creatinine and/or a fall in urine output. Kidney disease: improving global outcomes (KDIGO) Acute Kidney Injury Work Group.
Detect AKI by using any of the following criteria: A rise in serum creatinine of 26 micromol/L or greater within 48 hours. Be aware that in the absence of a baseline creatinine value, a high serum creatinine level may indicate AKI, even if the rise in creatinine over 48 hours is less than 26 micromol/L (particularly if the person has been ...
Feb 26, 2024 · Acute kidney injury (AKI) is a term used to describe when your kidneys are suddenly not able to filter waste products from the blood. This can happen within a few hours or a few days. For most people, AKI develops within 48 hours, but sometimes it can take as long as 7 days.
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