Acute Kidney Disease

What is Acute Kidney Disease?

Acute kidney disease or acute kidney injury occurs suddenly when your kidneys (two bean-shaped organs the size of your fist) are no longer able to filter waste products and toxins from your blood.

This condition develops rapidly, often in only a few days, as opposed to chronic kidney disease, which develops over months or years.

This condition is most common in people who are already in hospital, particularly in people who need intensive care.

Whilst the condition is serious and can be fatal, it is also very commonly reversible with prompt intervention, with little impact on lifespan, especially in people who are otherwise in good health.

Causes of acute kidney disease are varied and complex but generally the condition is more common in people over 65 and where there is an underlying kidney disease or kidney issue.

It is also more common in people who have high blood pressure, existing diabetes, heart disease, liver disease or peripheral artery disease, a condition which prevents adequate blood flow to the arms and legs.

Some medications can also cause kidney damage such as some blood pressure medications, chemotherapy, overuse of painkillers, antibiotics and proton-pump inhibitors (reflux medications).

Severe dehydration, allergic reactions, infections and severe burns are other causes.

In recent times Covid-19 has become a new and largely unreported driver of kidney disease, with up to 30% of people with Coronavirus developing an acute kidney injury.

Other causes of kidney disease include glomerulonephritis (inflammation of the kidney filters), red blood cell disorders such as Hemolytic Uremic Syndrome, or immune system disorders such as Lupus.

Sometimes an acute kidney injury can also occur in someone who has had a kidney transplant.

In some cases an AKI can resolve in days or weeks, mostly with treatments with fluids and antibiotics.

However in other cases the illness may be quite severe and recovery can take a few weeks or longer.

For people with a history of an acute kidney injury, this itself becomes an independent risk factor for later developing Chronic Kidney Disease, so following an acute kidney episode patients should have a kidney health check performed by their doctor every year for three years after the first episode.

What are the signs of an Acute Kidney Injury?

Symptoms and signs of an acute kidney injury include:

Fluid retention, which can cause swelling of the feet, ankles and legs
Chest pain and pressure
In severe cases, seizure or coma
Shortness of breath
Dry or itchy skin
Muscle cramps and muscle weakness
Frequent bathroom trips
Metallic taste in the mouth
Decreased urine output

What are the treatments for Acute Kidney Injury?

The treatment generally depends on the cause and many people will need to be in hospital during the treatment for a severe acute kidney injury, which can include temporary hemodialysis (dialysis purifies the blood).
Medicines to control electrolytes in your blood will also be used, along with treatments to ensure that the right amount of fluid in your blood is maintained.
When you go home, your doctor may advise you to follow a low-salt kidney friendly diet.
Remember, prevention is one of the best treatments for acute kidney injury, which means paying attending to OTC pain medications such as aspirin and acetaminophen, ibuprofen and naproxen sodium.
These medications can all increase the risk of kidney damage especially if you already have underlying kidney disease, diabetes or raised blood pressure.
The outcomes of acute kidney injury are highly variable and can include:
– Full recovery and normal kidney function, more achievable with early intervention.
– Partial recovery with some level of kidney function, but dialysis is not required
– Permanent kidney damage that requires dialysis or transplant.

Sources
*30% of people with Coronavirus developing an Acute Kidney Injury.