Acute Kidney Injury

Overview of Acute Kidney Injury (AKI)

Acute kidney injury (AKI), previously referred to as acute renal failure, is a sudden loss of kidney function, which can happen over a period of hours or days. This rapid decline affects the kidneys’ ability to filter waste, balance fluids, regulate electrolytes, and manage blood pressure. If not managed properly, AKI can lead to severe complications, including long-term kidney damage or chronic kidney disease (CKD). It can occur as a result of a variety of factors, such as:

• Dehydration or severe blood loss
• Exposure to certain medications or toxins
• Infections
• Severe illnesses like heart failure or liver disease
• Obstructions, such as kidney stones or enlarged prostate, blocking urine flow

At Southeast Kidney Associates, we understand how critical early detection and management of AKI can be for a patient’s recovery. Our team of nephrology experts provides comprehensive care tailored to each patient’s needs, ensuring that every individual receives timely and appropriate intervention.

What Causes Acute Kidney Injury? 

AKI is typically classified into three types depending on its cause:

1. Pre-Renal AKI: This occurs due to a sudden reduction in blood flow to the kidneys. Causes include severe dehydration, blood loss, or heart failure.
2. Intrinsic AKI: This type of AKI results from direct damage to the kidney tissue, often due to infections, toxins, or prolonged use of medications that may harm the kidneys.
3. Post-Renal AKI: AKI can also be caused by a blockage in the urinary tract, which prevents the normal flow of urine. This could be due to kidney stones, tumors, or an enlarged prostate in men.

Symptoms of Acute Kidney Injury

The signs and symptoms of AKI can be subtle, especially in the early stages. However, as the condition progresses, some common symptoms include:

• Decreased urine output or difficulty urinating
• Swelling in the legs, ankles, or around the eyes due to fluid retention
• Fatigue or feeling weak
• Shortness of breath
• Nausea or vomiting
• Confusion or difficulty concentrating
• Chest pain or pressure

Because AKI can develop quickly and may lead to serious complications, it is vital to seek immediate medical attention if any of these symptoms arise.

How to Prepare for Your Appointment

If you or a loved one have been diagnosed with or are at risk for acute kidney injury, your upcoming appointment with Southeast Kidney Associates is an essential step toward recovery. Preparing in advance will help you get the most out of your visit. Here are a few tips:

1. Medical History: Bring a detailed list of your medical history, including any chronic conditions like diabetes, high blood pressure, or heart disease. If you’ve recently had surgery or experienced an injury, it’s important to mention that as well.
2. Medication List: Create an updated list of all medications you’re currently taking, including prescription drugs, over-the-counter medications, and supplements. Some medications can be harmful to your kidneys, so your doctor will want to review them.
3. Lab Results and Medical Records: If you’ve recently had any blood tests, imaging studies, or urinalysis, bring those results to your appointment. This will help your nephrologist evaluate your current kidney function and determine the severity of the injury.
4. Symptom Diary: Keeping a log of your symptoms, including when they started, how severe they are, and if they change throughout the day, can be helpful information for your doctor.
5. Questions for Your Doctor: Write down any questions or concerns you have about your condition. This might include questions about the diagnostic process, treatment options, lifestyle changes, or possible outcomes. Your nephrologist will appreciate your proactive approach and will be able to address your concerns more thoroughly.

What to Expect During Your Appointment

At Southeast Kidney Associates, we take a patient-centered approach to managing AKI. Your appointment will be thorough and structured to ensure we capture all the critical information necessary for an accurate diagnosis and treatment plan.

1. Medical Examination and History: Your nephrologist will start with a detailed review of your medical history and any symptoms you’re experiencing. This is followed by a physical exam where they will assess any signs of fluid retention, blood pressure changes, or other physical indicators of kidney stress.
2. Diagnostic Testing: To understand the extent and cause of your AKI, several diagnostic tests may be ordered, including:

• Blood Tests: These measure kidney function by evaluating levels of creatinine and blood urea nitrogen (BUN), which tend to rise when the kidneys are not functioning properly. These tests also measure your estimated glomerular filtration rate (eGFR), which shows how well your kidneys are working to filter your blood, and this number tends to decline when the kidneys are not functioning properly. Blood tests also help assess electrolyte imbalances and other markers of kidney health.
• Urinalysis: Urine tests can provide critical information about how well your kidneys are filtering waste. The presence of protein, blood, or other abnormalities may indicate damage to the kidneys.
• Imaging: Ultrasound or CT scans may be used to visualize the kidneys and urinary tract. Imaging can help identify any blockages or structural issues, such as kidney stones or tumors, that may be causing AKI.
• Biopsy: In some cases, a kidney biopsy may be required to get a closer look at kidney tissue and identify the underlying cause of the injury.

Treatment Options for Acute Kidney Injury

Treatment for AKI will vary based on the underlying cause and severity of the condition. At Southeast Kidney Associates, our goal is to restore kidney function as quickly as possible, prevent further damage, and manage any complications that may arise.

1. Fluid and Electrolyte Management: Many patients with AKI require careful management of fluids and electrolytes. Depending on whether you’re retaining fluids or dehydrated, your nephrologist may recommend specific IV fluids or medications to balance the levels of sodium, potassium, and other electrolytes in your body.
2. Medication Adjustments: Your nephrologist may need to adjust or temporarily stop certain medications that could be contributing to kidney damage. For example, some pain medications, antibiotics, and blood pressure medications can worsen kidney function.
3. Addressing the Underlying Cause: Treating the root cause of your AKI is critical for recovery. If your AKI is due to an infection, antibiotics or other medications may be prescribed. If a blockage is detected, procedures to remove the obstruction (such as surgery or catheter placement) may be recommended.
4. Monitoring and Follow-Up: Once your treatment plan is in place, your recovery will be closely monitored. Regular blood tests and follow-up appointments will ensure that your kidneys are healing and that you are not developing any long-term complications.
5. Dialysis: In severe cases where kidney function does not improve with conservative measures, dialysis may be required. Dialysis is a process where a machine takes over the job of your kidneys by filtering waste and excess fluid from your blood. While this is usually a temporary treatment during AKI, in some cases, prolonged dialysis may be necessary.

Long-Term Outlook

With early detection and proper treatment, many patients recover fully from AKI without long-term kidney damage. However, it’s important to stay vigilant and work with your nephrologist to prevent future kidney injuries. Managing underlying conditions like diabetes, hypertension, and heart disease is key to maintaining healthy kidneys. Additionally, lifestyle changes, such as staying hydrated, avoiding unnecessary medications that harm the kidneys, and managing blood pressure, are essential for preventing AKI recurrence.

At Southeast Kidney Associates, we are dedicated to providing personalized care that helps you recover from AKI and supports your overall kidney health. If you or a loved one are experiencing symptoms of AKI, please contact us to schedule an appointment today.