Acute Kidney Injury

Question 1

Definition of Acute Kidney Injury

Answer 1

Acute kidney injury is defined as an abrupt decline in kidney function, typically characterized by an increase in serum creatinine levels or a decrease in urine output.

The severity of AKI is classified into three stages based on the level of kidney dysfunction.

Question 2

Causes of Acute Kidney Injury

Answer 2

Prerenal causes: These are conditions that disrupt blood flow to the kidneys, leading to inadequate perfusion. Common causes include dehydration, severe bleeding, heart failure, or decreased blood volume.

Intrinsic renal causes: These involve damage to the kidney tissue itself. Causes may include acute tubular necrosis (ATN) due to ischemia or toxic injury, glomerulonephritis, interstitial nephritis, or acute renal artery obstruction.

Postrenal causes: These occur when there is an obstruction of urine flow from the kidneys. Causes may include kidney stones, tumors, or urinary tract obstruction.

Question 3

Diagnosis of Acute Kidney Injury

Answer 3

Medical history and physical examination: Evaluating symptoms, risk factors, and potential causes of kidney injury.
Laboratory tests: Measuring serum creatinine levels to assess kidney function. An increase in creatinine levels indicates impaired kidney function. Other blood tests may be done to evaluate electrolyte imbalances and assess overall health.
Urinalysis: Analyzing a urine sample to detect the presence of blood, protein, or other abnormalities.
Imaging studies: Imaging techniques like ultrasound or CT scans may be performed to identify any structural abnormalities or obstruction.
Renal biopsy: In some cases, a biopsy may be required to determine the underlying cause of AKI.

Question 4

Lab alterations of Acute Kidney Injury

Answer 4

Lab Alterations:
In acute kidney injury, the following lab alterations may be observed:

Elevated serum creatinine levels: Increased creatinine levels indicate impaired kidney function.
Decreased urine output: The kidneys may produce significantly less urine than usual or stop producing urine altogether.
Electrolyte imbalances: There may be disturbances in electrolyte levels, such as high potassium (hyperkalemia), low sodium (hyponatremia), or imbalances in calcium, phosphate, or acid-base levels.

Question 5

Symptoms of Acute Kidney Injury

Answer 5

Symptoms:
The symptoms of acute kidney injury can vary depending on the underlying cause and the severity of kidney dysfunction. Common symptoms may include:

Decreased urine output or no urine production
Swelling in the legs, ankles, or face
Fatigue and weakness
Shortness of breath
Nausea and vomiting
Confusion or altered mental state
Chest pain or pressure (if related to fluid overload)
High blood pressure (if caused by certain conditions)

Question 6

Treatment of Acute Kidney Injury

Answer 6

Treating the underlying cause: Identifying and addressing the specific cause of AKI, such as restoring blood flow, managing infections, or removing obstructions.

Fluid and electrolyte management: Balancing fluid intake and output, correcting electrolyte imbalances, and ensuring adequate hydration.

Medications: Depending on the underlying cause, medications may be used to manage symptoms, control blood pressure, or treat infections.

Dialysis: In severe cases of AKI, when the kidneys are unable to effectively filter waste products and maintain fluid balance, dialysis may be necessary. Dialysis involves the use of a machine to filter waste products and excess fluid from the blood.

Supportive care: Providing supportive measures to manage symptoms, maintain nutrition, and prevent complications.