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Acute Kidney Injury (AKI)

Overview

Acute kidney injury (AKI) is a sudden and often reversible decrease in kidney function over a short period. If detected and treated early, kidney function can frequently be restored. AKI can result from severe dehydration that is experienced in cases of diarrhoea, burns, secondary sepsis, treatment with certain medications, or complications following surgery.

AKI is usually classified into three main types based on the location or cause of the kidney injury:

  • Pre-renal AKI: It is caused by decreased blood flow to the kidneys, for example in cases of dehydration, blood loss, or low blood pressure.
  • Intrinsic (renal) AKI: It is caused by direct damage to the kidneys themselves, such as that caused by toxins, medications, infections, or inflammation of the kidney tissue.
  • Post-renal AKI: It is caused due to the obstruction of the flow of urine after it leaves the kidneys. Generally, this obstruction is caused by kidney stones, enlarged prostate, or urinary tract strictures.

The presentation of AKI can vary depending on severity:

  • Mild cases may be asymptomatic and identified only through routine laboratory tests.
  • Severe cases may present with:
    • Reduced urine output
    • Swelling in the face and feet
    • Reddish discoloration of urine
    • Abdominal pain

The underlying causes of AKI can be classified as follows:

  • Pre-renal AKI develops when blood flow to the kidneys is reduced, for examples due to dehydration, low blood pressure, or heart failure.
  • Intrinsic renal AKI develops when the kidney tissue is directly damaged, by infections, toxins, or autoimmune reactions.
  • Post-renal AKI develops when there is an obstruction to the urine flow through the urinary tract due to kidney stones, tumours, or an enlarged prostate.

Accurate diagnosis of AKI involves:

  • Urine tests to check for abnormalities and kidney function.
  • Blood tests to assess how well the kidneys are working.
  • Imaging studies, such as an ultrasound, to check kidney size and detect any structural issues.

The management of AKI is tailored to address the underlying cause and support kidney recovery:

  • Rehydration therapy for patients with fluid loss due to diarrhoea or burns
  • Antibiotic therapy for treating infections, such as sepsis, which may cause AKI
  • Discontinuation of nephrotoxic medications that can harm the kidneys
  • In some severe cases, advanced interventions such as immunosuppressive therapy or temporary dialysis may be necessary to support kidney function until recovery.

You should consult a doctor immediately if you notice any of the following:

  • Sudden or severe reduction in urine output
  • Swelling in the face, hands, or feet
  • Blood in the urine
  • Fever, chills, or any signs of infection
  • Severe fatigue, nausea, or vomiting
  • Persistent back or abdominal pain

While not all cases of AKI can be prevented, the following steps may reduce the risk of developing this condition:

  • Maintain adequate hydration, particularly during illness or in hot weather.
  • Use medications carefully and only under a doctor’s supervision to avoid kidney damage.
  • Treat infections or illnesses promptly to protect kidney function.
  • Schedule regular health check-ups if you have chronic conditions, such as diabetes, hypertension, or a previous history of kidney issues.

A nephrologist (kidney specialist) should be consulted for the diagnosis and management of AKI.

Disclaimer:

The information in this Health Library is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional with any questions about a medical condition or before starting any treatment. Use of this site and its content does not establish a doctor–patient relationship. In case of a medical emergency, call your local emergency number or visit the nearest emergency facility immediately.