Medicine : Comprehensive Overview of Acute Kidney Injury: Causes, Diagnosis, Management, and Prevention Strategies for Improved Outcomes

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 DEFINITION

Acute Kidney Injury (AKI) is a sudden and often reversible decline in kidney function, resulting in the kidneys' inability to effectively filter waste, maintain fluid balance, and regulate electrolytes. It can range from mild to severe and may lead to complications if not addressed promptly.


Causes of AKI


AKI is classified based on the underlying cause into three categories:

1. Prerenal AKI (Reduced blood flow to the kidneys):


• Dehydration (due to vomiting, diarrhea, or inadequate fluid intake).

• Severe blood loss (hemorrhage).

• Low blood pressure (shock, sepsis, or heart failure).

• Use of certain medications (e.g., NSAIDs, ACE inhibitors).

2. Intrinsic (Intrarenal) AKI (Damage to the kidney tissue):


• Acute tubular necrosis (due to prolonged ischemia or toxins).

• Glomerulonephritis (inflammation of the kidney's filtering units).

• Acute interstitial nephritis (allergic reaction, infections, or drugs like antibiotics).

• Rhabdomyolysis (muscle breakdown releasing myoglobin, toxic to kidneys).

3. Postrenal AKI (Obstruction of urine flow):


• Kidney stones.

• Enlarged prostate (benign prostatic hyperplasia).

• Tumors compressing the urinary tract.

• Urethral strictures or bladder dysfunction.

Symptoms of AKI


• Decreased urine output (oliguria) or no urine output (anuria).

• Swelling (edema), especially in the legs and around the eyes.

• Fatigue or weakness.

• Confusion or altered mental status.

• Shortness of breath (fluid overload in the lungs).

• Nausea and vomiting.

• Irregular heartbeat (due to electrolyte imbalances).

• High blood pressure.

Diagnostic Tests


Blood Tests:

• Serum creatinine (to assess kidney function).

• Blood urea nitrogen (BUN).

• Electrolytes (potassium, sodium, calcium, and phosphorus).

Prevention of AKI


• Stay hydrated, especially during illness or physical exertion.

• Avoid unnecessary use of nephrotoxic medications.

• Monitor kidney function closely in high-risk individuals (e.g., those with diabetes, hypertension, or heart disease).

• Manage infections and chronic conditions effectively.

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