Kidney Failure: Signs, Causes, Remedies, and Further Details
Acute Kidney Injury (AKI), a sudden and frequently reversible decline in kidney function, can affect a significant number of people, particularly those who are critically ill or already hospitalized.
The condition can occur due to three main reasons: reduced blood flow, direct damage to the kidneys, and blockage of the urinary tract. Critically ill people in an Intensive Care Unit (ICU) have the highest risk of developing AKI, with up to 67% of those in an ICU experiencing it.
Risk factors for AKI include advanced age, preexisting renal disease, volume depletion or insufficient intravascular volume, use of nephrotoxic drugs, critical illness-related factors, perioperative factors, and other patient-related factors such as female sex and low body mass index.
Advanced age and preexisting chronic kidney disease (CKD) reduce renal reserve, making kidneys more vulnerable to injury. Drug-induced injury occurs mainly via proximal tubular toxicity or mitochondrial damage. Hemodynamic factors, such as restrictive intraoperative fluid administration, cause hypovolemia and ischemic injury to the kidney, strongly increasing AKI risk. Sepsis and systemic inflammation lead to endothelial dysfunction and renal hypoperfusion contributing to AKI risk.
In more severe cases, people with AKI might experience symptoms including weakness and tiredness, urinating less, swelling in the feet, ankles, or legs, nausea, a feeling of not being able to catch their breath, confusion, pressure or pain in their chest, seizures or coma.
If the condition causes severe damage, it can lead to chronic kidney disease over time, which can result in end-stage kidney failure. Complications from AKI can include high potassium levels, metabolic acidosis, swelling in the lungs from fluid overload, cardiovascular disease, neurological problems, and gastrointestinal problems.
Early identification and prevention efforts usually target these factors. Early treatment of AKI enables most people's kidney function to return to normal or close to normal. Treatment for AKI can include medications to adjust electrolytes and control blood pressure, diuretics, temporary dialysis for people with severe AKI, diet changes restricting fluid, salt, and foods high in potassium.
The CDC does not have prevention recommendations specific to AKI, but it offers healthy kidney tips, including controlling risk factors, following a doctor's instructions for taking medications, quitting smoking, maintaining a healthy weight, getting regular exercise, eating more fruits and vegetables, avoiding foods with high salt quantities, getting kidneys checked during doctor checkups. A person who has risk factors for AKI may wish to discuss the medications they take with a doctor.
In the United States, approximately 1% of people admitted to a hospital may experience AKI, with the incidence ranging from approximately 2-5% during hospitalization. People with a milder case of AKI may not have any symptoms.
AKI is defined by the KDIGO classification, which involves increases in serum creatinine, decreases in urine volume, or both. The diagnostic process for AKI involves a physical exam, medical history review, checking other organs for symptoms, a basic metabolic panel, glomerular filtration rate, urinalysis, urine output measurement, imaging (CT scan and ultrasound), and kidney biopsy (uncommon).
The outlook for AKI depends on the cause, duration of dysfunction, and presence of underlying kidney disease. When AKI is chronic, at least one-third of people may require permanent dialysis. The in-hospital death rate for people with AKI is high, particularly among those who need dialysis. Factors that can complicate a person's outlook include being of advanced age, producing only very small amounts of urine, needing blood transfusions, using drugs that constrict blood vessels, having low blood pressure, having dysfunction in multiple organs.
AKI can affect other organs, including the lungs, heart, and brain. It's crucial to understand the risks, symptoms, and treatment options for AKI to ensure timely and effective care for those affected.
- Dehydration as a result of insufficient intravascular volume, a risk factor for Acute Kidney Injury (AKI), can lead to health issues, particularly in critically ill individuals.
- Chronic kidney disease (CKD), a potential complication from severe AKI, can increase the risk of end-stage kidney failure and may require permanent dialysis, especially when the condition is chronic.
- Neurological problems can arise as complications from AKI, signifying that AKI can affect not only the kidneys but also other organs, such as the brain.
- In the health-and-wellness sphere, the CDC does not have specific prevention recommendations for Acute Kidney Injury, but it encourages measures like controlling risk factors, following medication instructions, quitting smoking, maintaining a healthy weight, getting regular exercise, and consuming a balanced diet with low salt content to promote overall kidney health.
