Acute kidney injury (AKI) is a sudden drop in kidney function that develops over hours or days. It is often reversible when the cause is found and treated early, but it needs prompt medical attention. Dr. Satarupa Deb evaluates and manages AKI at Bombay Hospital, South Mumbai.
What Is Acute Kidney Injury?
Your kidneys filter waste, balance fluids and salts, and help control blood pressure. In acute kidney injury, this filtering suddenly slows down, so waste products such as creatinine and urea build up in the blood and the body may retain fluid.
AKI was previously called acute renal failure. It can range from a mild, temporary rise in creatinine to severe kidney failure that needs dialysis for a period of time. Many people recover well, but an episode of AKI may increase the future risk of chronic kidney disease, so follow-up matters.
Common Causes and Risk Factors
Doctors usually group the causes of AKI into three types: reduced blood flow to the kidneys, direct damage to the kidney tissue, and blockage of urine flow.
- Dehydration from diarrhoea, vomiting, heat exposure or poor fluid intake
- Severe infections and sepsis, including dengue, malaria and leptospirosis seen during the monsoon
- Low blood pressure, heavy blood loss, heart failure or major surgery
- Certain medicines, such as painkillers (NSAIDs), some antibiotics and contrast dye used in scans
- Blockage from kidney stones, an enlarged prostate or tumours
- Higher risk in older adults and people with diabetes, high blood pressure or existing kidney disease
Symptoms to Watch For
AKI may cause few symptoms at first and is sometimes picked up only on a blood test. When symptoms appear, they may include:
- Passing much less urine than usual
- Swelling of the legs, ankles or face
- Tiredness, weakness, nausea or loss of appetite
- Breathlessness due to fluid build-up
- Confusion or drowsiness in more severe cases
How AKI Is Diagnosed
Diagnosis is based on a rise in serum creatinine and/or a fall in urine output. Your nephrologist will also look for the underlying cause, because treating the cause is the key to recovery.
- Blood tests for creatinine, urea, electrolytes and blood counts
- Urine tests to check for protein, blood and cells
- Ultrasound of the kidneys to look for blockage or structural problems
- A review of all recent medicines and illnesses
- A kidney biopsy in selected cases when the cause is unclear
Treatment of Acute Kidney Injury
Treatment focuses on correcting the cause and protecting the kidneys while they recover. This may include careful fluid replacement, treating infection, stopping or adjusting medicines that can harm the kidneys, and relieving any blockage in the urinary tract.
Your doctor will closely monitor fluids, blood pressure, potassium and acid levels. If waste products, fluid or potassium rise to dangerous levels, temporary dialysis may be needed until kidney function improves. After recovery, regular check-ups help detect any lasting kidney damage.
When to See a Nephrologist
Seek medical help promptly if you notice a sudden drop in urine output, new swelling or breathlessness, or if a blood test shows rising creatinine. People who have had an episode of AKI, especially with diabetes or high blood pressure, benefit from a nephrologist review to check recovery and reduce future risk.
Frequently Asked Questions
Is acute kidney injury reversible?
In many cases, yes. When the cause is identified and treated early, kidney function often recovers partly or fully. Some people may be left with reduced kidney function, which is why follow-up tests are important.
Will I need dialysis for AKI?
Most people with AKI do not need dialysis. It may be required for a short time if kidney function is severely reduced or if fluid, potassium or acid levels become dangerous. Many patients are able to stop dialysis once the kidneys recover.
Can painkillers cause kidney injury?
Some common painkillers, known as NSAIDs, may reduce blood flow to the kidneys and can contribute to AKI, especially when a person is dehydrated or already has kidney disease. Always check with your doctor before taking painkillers regularly.
How can I lower my risk of AKI?
Stay well hydrated, especially during illness or hot weather, avoid unnecessary painkillers, and keep diabetes and blood pressure under control. If you have kidney disease, tell your doctors before any scan that uses contrast dye.
Consult Dr. Satarupa Deb
If you or a family member has a sudden change in kidney function, book a consultation with Dr. Satarupa Deb at Bombay Hospital, South Mumbai, for timely evaluation and care.
This page is for general information only and is not a substitute for a medical consultation. Please consult a qualified doctor for diagnosis and treatment.