09-10-2024 07:42 AM

Acute Kidney Injury (AKI) Symptoms, Causes, and Treatment

Understanding Acute Kidney Injury

Acute kidney injury (AKI) occurs when the kidneys fail to filter the blood, accumulating wastes and toxins in the body. In AKI, the kidneys suddenly lose their ability to function within hours or days, which ranges from mild to severe. It is most common in hospitalised patients who need intensive care.

AKI differs from chronic kidney disease (CKD) because AKI develops more rapidly and is often reversible. At the same time, CKD progresses slowly over months or years and results in permanent loss of kidney function.

Learn more about kidney cysts and how they can affect kidney function

The leading causes of Acute Kidney Injury include:

Infection.
Insufficient blood flow to the kidneys.
Certain medicines that damage the kidneys. (common OTC medications like NSAID)

The KDIGO provided the following diagnostic criteria for acute kidney injury.

Sudden increase in serum creatinine levels (by 0.3 mg/dL or more within 48 hours)
Reduced urine output (less than 0.5 mL/kg per hour for more than 6 hours)
Sudden increase in creatinine level by 1.5 times the baseline over the previous 7 days.

The kidneys are essential in filtering waste products, balancing fluids and electrolytes, maintaining blood pressure, and producing red blood cells. In acute kidney injury, the kidneys fail to perform their vital functions, leading to waste accumulation, electrolyte imbalances, and fluid overload. Certain over-the-counter medicines, like NSAIDs, can damage the kidneys and lead to complications such as metabolic acidosis and hyperkalemia.

In some cases, acute kidney injury(AKI) acts as a reversible disease. It can be recovered on early diagnosis with proper management and treatment. In severe cases, it could be fatal, and if left untreated, it leads to chronic kidney failure. It also affects the brain, heart, and lungs and even causes the death of an individual.

According to the Centers for Disease Control and Prevention (CDC), Acute Kidney Injury (AKI) affects about 30% of hospitalised patients and is more common in higher-end ICUs. Typically, AKI occurs in 5-7% of hospitalised patients.

The World Health Organization (WHO) highlighted the results of a global mortality rate of 1.7 million people dying annually due to AKI-related complications. They need proper management, better preventive measures, and early diagnosis strategies.

2. Causes of Acute Kidney Injury (H2)

What are the main causes of AKI?

The causes of acute kidney injury include

Severe Dehydration
Sepsis
Decreased blood flow to the kidneys.
Damage due to the kidneys infection or other complications
Blockage of ureters.

Severe Dehydration

Dehydration occurs when the body loses more fluid than it intakes. It disrupts the normal balance and causes the loss of essential electrolytes required for the body's normal functioning. Dehydration also results in decreased blood volume, which affects many organs, including the kidneys, and leads to acute kidney injury (AKI).

Insufficient intake of consumption of water can cause dehydration due to lack of access to water or negligence in drinking fluid. The excessive fluid loss due to vomiting, diarrhoea, excessive sweating and medical conditions like diabetes mellitus and kidney disease also results in severe dehydration that contributes to acute kidney injury (AKI).

Sepsis

Sepsis is a life-threatening complication of a blood infection that triggers inflammatory responses throughout the body. It results in systemic vasodilation and also damages other organ systems, including the kidneys, resulting in acute kidney injury. The complications from sepsis, such as reduced blood flow, often result in symptoms like shortness of breath or low urine output.

Decreased Blood Flow to the Kidneys

Dehydration in the body may be due to inadequate intake of fluid or reduced kidney perfusion that results in acute kidney injury. It also leads to slower blood flow to the kidneys. The decreased blood flow may be due to

Dehydration
Infection or sepsis
Overuse of medications that damage kidneys like NSAIDs, ibuprofen (Advil, Motrin IB, others), or naproxen sodium (Aleve).
Blood or fluid loss due to accident
Decreased blood pressure due to antidiuretic medicines.
Heart failure or heart disease.
Liver cirrhosis or failure.
Any severe life-threatening allergic reaction (anaphylaxis)
Severe burns

Damage to the Kidneys

Damage to the kidneys also leads to the condition of acute kidney injury. It includes

The swelling inflammation of tiny filters of the kidneys is termed glomerulonephritis (inflammation of the tiny filters in the kidneys).
Damage to kidneys due to intake of certain medications like chemotherapy drugs, antibiotics and some dyes used during imagining tests during diagnosis.
Severe infection due to COVID-19
Kidneys are damaged due to the intake of some toxins like alcohol, metal, or cocaine.
Blood clots in veins or arteries around kidneys.
Deposition of cholesterol that blocks blood flow towards kidneys.
Hemolytic uremic syndrome (a condition in which red blood cells are destroyed prematurely)
Scleroderma (a rare diseases that affect the skin and connective tissues)
Thrombotic thrombocytopenic purpura(A rare blood disorder)
Rhabdomyolysis(Muscle tissue breakdown,)
Tumour lysis syndrome (Breakdown of tumour cells leads to the release of toxins and injury to kidney tissues)

Urine blockage in the kidneys

Urinary obstruction is a condition in which the urinary pathways are blocked, and urine cannot be excreted outside the body. The blockage leads to acute kidney injury. It may be due to

Kidney stones.
Enlarged prostate.
Blood clotting in the urinary tract.
Bladder cancer.
Prostate cancer.
Cervical cancer.
Colon cancer.
Growth pushing on the ureters.
Nerve damage of the bladder.

How Causes of AKI Interrelate with Other Health Conditions

Acute Kidney Injury (AKI) is a common complication that occurs with other chronic health conditions. AKI coexists with other diseases, such as hypertension, diabetes, heart failure, liver disease, and chronic kidney disease (CKD). So, proper management of these complications helps better treat acute kidney injury.

Hypertension and Diabetes

Hypertension and diabetes are the two most common chronic conditions that increase the risk of acute kidney injury (AKI). Consistently high blood pressure damages the kidneys' blood vessels, reducing their ability to filter waste properly.

Similarly, in diabetes, increased blood sugar levels result in the thickening of the kidney's filtering units. These complications lead to kidney damage, especially during acute illnesses or procedures.

According to the National Institute of Health (NIH), about 25-40% of patients in hospitals with diabetes or hypertension are diagnosed with AKI.

Heart Failure

Heart failure and kidney disease are also interrelated. In heart failure, the heart reduces its pumping efficiency, which leads to decreased kidney perfusion. The kidneys try to maintain the heart's burden and create a feedback loop, often known as cardiorenal syndrome, which results in acute kidney injury.

The National Institute of Health (NIH) highlighted that about 20-33% of cardiac failure hospitalised patients are diagnosed with acute kidney injury, which indicates a strong link between cardiac dysfunction and kidney injury.

Liver Disease

Liver disease, including cirrhosis, is another major contributor to acute kidney injury. Cirrhosis leads to a significant decrease in blood volume, forcing the kidneys to retain water and sodium. This compensatory mechanism strains the kidneys and leads to acute kidney injury.

According to the National Institute of Health (NIH), a study conducted on hepatology shows that about 50% of patients with cirrhosis are more prone to develop AKI during their disease progression.

With multiple causes contributing to AKI, identifying its early symptoms is essential for effective treatment and prevention of further complications.

Chronic Kidney Disease (CKD)

Patients with chronic kidney disease are more likely to suffer from acute kidney injury. CKD disappears the ability to cope with infection, dehydration, or drug toxicity that triggers AKI. There is rapid progression and irreversible development of end-stage renal disease (ESRD) in people who suffer from both CKD and AKI.

After understanding the causes of Acute Kidney Injury (AKI), it's essential to recognise its symptoms for proper diagnosis.

Diagram of interplay between different organ systems.

3. Symptoms and Diagnostic Criteria of Acute Kidney Injury

The symptoms of acute kidney injury(AKI) include

Low urine output.
Shortness of breath and oedema (due to fluid accumulation)
Fatigue
Nausea, weakness and itching
Pain in the abdomen or below the rib cage.
Fluctuation in the heartbeat.
Loss of appetite.
Chest pain
Seizures or even coma in severe cases.

In some cases, acute kidney injury does not show symptoms. However, it can be diagnosed through lab tests for other complications commonly performed to confirm the diagnosis.

Blood tests: Blood is taken as a sample to determine the level of urea and creatinine. This helps to determine whether the kidneys are functioning properly.

Urine output measures. The frequency of urine output in 24 hours also helps to determine the cause of kidney dysfunction.

Urine tests: Urine tests are a common way to identify kidney-related problems. A urinalysis test can also indicate kidney failure.

Imaging tests. Imaging tests, including ultrasound and CT scans, help identify any kidney damage or injury because they provide a proper scanned image of the kidneys.

Kidney Biopsy: Biopsy is a surgical process in which a small kidney sample is taken for testing. This piece of kidneys is further investigated in labs to identify any kidney damage.

Diagnostic Criteria of Acute Kidney Injury AKI

According to Kidney Disease Improving Global Outcome (KDIGO) The diagnostic method for acute kidney injury is based on serum creatinine levels and urine output. It is widely accepted as a diagnostic method for acute kidney injury. The procedure includes

Increased serum creatinine level ≥0.3 mg/dL within 2 days
Increased level of serum creatinine ≥1.5 times baseline, also known or presumed to occur within 7 days
Urine output < 0.5 mL/kg/hour for six hours

Early Detection Signs Of Acute Kidney Injury AKI

Early detection of acute kidney injury allows early treatment to prevent further complications. This includes medication adjustments, fluid management, and prevention of additional kidney damage, especially in people who are at higher risk, like diabetes, hypertension, or chronic kidney disease (CKD).

The clinical findings highlighted by the American Academy of Family Physicians show that early AKI management enhances patient survival and lowers the need for dialysis.

4. Treatment and Management of Acute Kidney Injury

Acute Kidney Injury (AKI) is usually treated in hospitals. A patient's hospital stay depends on the severity of the kidney injury and the individual patient's health. The complete recovery and treatment depend on the leading cause of kidney injury. The standard treatment options for acute kidney injury include medicines, dialysis, and lifestyle changes to treat that particular cause.

Medications to Treat Acute Kidney Injury (AKI)

These medicines help treat complications that are causing acute kidney injury.

IV Fluid: IV fluid is necessary for balancing and adjusting fluid. It is helpful in kidney injury caused by sepsis (lack of fluid in the blood) to restore body fluids according to requirements. However, if AKI causes excess fluid accumulation in the body, it leads to swelling in the extremities (hand and foot).
Diuretics: If AKI causes excess fluid accumulation in the body, it leads to swelling, especially in the extremities (hand and foot). In this case, diuretics are prescribed as a treatment option to remove excess fluid from the body. However, it is not prescribed if the patient is hypovolemic.
Potassium Binders: Potassium regulates blood pressure and other necessary body functions. In AKI, the kidneys fail to filter potassium from the blood. Potassium binders are prescribed for treatment purposes to keep potassium from building up. It includes sodium zirconium cyclosilicate (Lokelma) or patiromer (Veltassa). However, excess potassium in the body causes irregular heartbeats (arrhythmia) and muscular weakness.

AKI is usually linked with hyperphosphatemia and secondary hypocalcemia due to phosphate retention and impaired vitamin D metabolism.

Dialysis as a Treatment Option

If wastes build up in the body, dialysis is recommended for the patient with AKI to remove poison from the blood. Hemodialysis is usually prescribed, which helps remove poison and excess fluid through a hemodialysis machine.

Dialysis also helps remove excess potassium from the body and maintain electrolyte balance. During dialysis, blood is filtered through a dialysis machine, which filters waste and returns the cleaned blood to the body.

Lifestyle and Supportive Measures

Besides medications and dialysis options, lifestyle changes and dietary modifications play an essential role in managing the conditions of acute kidney injury and help speed up the recovery process.

Dietary modifications include reducing salt intake to control blood pressure and kidney workload, restricting protein intake to reduce urea waste, and limiting fluid restriction to lower urine output. These modifications are necessary to reduce the kidney's overall workload and help prevent further damage.
Effective fluid management is also necessary to recover from acute kidney injury. It is essential to maintain a balance between hydration and fluid overload. Monitoring daily fluid intake and weight management helps avoid complications like cardiovascular problems in people with low urine output.

Monitoring and Adjusting Treatments

Continuous monitoring of kidney functions and other vital parameters helps manage acute kidney injury complications successfully. The following points should be considered to overcome complications of acute kidney injury.

1. Regular Assessment of Kidney Function

The renal patient is prescribed to monitor blood test values, including serum creatinine, blood urea nitrogen (BUN), and electrolytes (e.g., potassium, sodium). This helps assess the improvement during treatment and the extent of kidney damage. Moreover, close observation of urine output also helps track the recovery of kidney damage. And glomerular filtration rate (GFR) would provide a more comprehensive overview of kidney function monitoring.

2. Adjusting Treatment Plans

Treatment plans should be modified according to the improvement and recovery of the kidneys. For example, while on treatment, reducing the intake of drugs like diuretics or adjusting the frequency of dialysis is necessary. These modifications depend on specific factors like the age of the patient, comorbidities and underlying causes of acute kidney injury (AKI)

Emerging Treatments and Research

The latest advancements in acute kidney injury focus on preventive therapies and unique methods to enhance early recovery. These involve using antioxidants and some anti-inflammatory substances, which reduce the extent of renal injury in acute illness.

1. Latest Advancements in AKI Treatment Protocols

Recent developments include renoprotective agents for acute kidney injury and drug therapies designed to reduce the risk factors, specifically surgical or contrast procedures. These advanced protocols aim to prevent renal ischemia and nephrotoxicity.

2. Ongoing Clinical Trials and Innovative Therapies

Stem cell therapy aims to repair injured kidney tissues, which is another development in renal treatment potential. As clinical trial treatment procedures are constantly being researched and developed, new treatment protocols are under investigation.

Management Strategies for Different Stages of AKI

Acute kidney injury (AKI) management depends on the stage and severity of kidney health.

Early Stage involves treating an underlying cause (e.g., infection, drug toxicity) or modifying to address symptoms with pharmaceuticals or fluids.
Moderate Stage It involves active fluid management, diuretics use, and active progression assessment.
Severe Stage: May require renal replacement therapy (dialysis) and continuous management of morbidities like hyperkalemia or acidosis. This stage involves monitoring and supportive care, which is essential to prevent further deterioration.

For Example:

According to KDIGO, studies show that early intervention with medicines (diuretics) and fluid management successfully prevent the progression of acute kidney injury (AKI).

Dialysis has also been shown to be effective in managing severe cases of AKI, with improved survival rates when initiated at the appropriate time. However, Improving Global Outcomes (KDIGO) also highlighted that the time of dialysis should depend on clinical judgement and patient condition rather than a fixed schedule.

5. Preventing Acute Kidney Injury: Best Practices

Early Acute Kidney Injury (AKI) can be avoided by implementing measures to preserve renal function. It can also be prevented by maintaining blood volume, blood pressure, and fluid balance in patients with other complications like severe burns, trauma, haemorrhage, or other major surgeries.

Maintaining Adequate Hydration

Staying well-hydrated is essential to ensure that kidneys work correctly. Insufficient fluid intake affects the kidneys and causes kidney injuries. Thus, dehydration can cause great harm, especially for individuals with other comorbidities (suffering from different health conditions like diabetes). Drinking 8 to 10 glasses of water daily is recommended, regardless of the climate, workload, and activity levels.

Managing Blood Pressure

High blood pressure is dangerous for kidney health. Avoiding factors that increase blood pressure, like excessive salt consumption and regular physical activity, also reduces the chances of developing acute kidney injury (AKI). In case of high blood pressure or hypertension, a medicine should be taken according to a doctor's prescription.

Avoiding Nephrotoxic Drugs

Nephrotoxic drugs should be avoided, including non-prescribed pain relievers like nonsteroidal anti-inflammatory drugs (NSAIDs) (Ibuprofen) and other antibiotics. Avoiding these drugs using their alternatives or limiting doses can prevent the risk of kidney damage. As with any medication changes, it is advisable to consult a doctor.

Monitoring Kidney Function in High-Risk Individuals

A person with one or more of these underlying diseases—diabetes, hypertension, and others — is especially at higher risk of getting AKI. Annual kidney function tests are helpful when screening for any sign of functional decline. Small changes, such as kidney dysfunction, can be detected by checking the blood levels of creatinine or through urine tests.

Implementing Safe Practices to Prevent Infections

Several infections and inflammations, such as sepsis, may result in AKI. Avoiding infections that may lead to inflammation in the kidneys, such as following proper hygiene practices, washing hands, and adequate immunisation when necessary, decreases the rates of AKI. Maintain a healthy lifestyle. Exercise, eating right, and drinking little or no alcohol aid in preventing acute kidney failure.

6. Complications of Acute Kidney Injury

Acute kidney injury builds up waste products in the blood, making it harder to maintain fluid balance and minerals in the body. If not treated properly on time, it can cause chronic kidney disease and renal failure. It also affects other organs like the brain, heart and lungs. The severe complications of acute kidney injury can cause

Hyperkalemia—In severe cases, the increased potassium levels in the blood result in muscle weakness, arrhythmias (irregular heartbeat), and even paralysis.
Excessive Fluid Accumulation- too much fluid in the body causes swelling in arms and legs (oedema) or in the lungs (pulmonary oedema)
Metabolic Acidosis- AKI causes blood to turn acidic, which causes nausea, drowsiness, vomiting and breathlessness
Chronic Kidney disease- if left untreated, acute kidney injury can result in the progression of CKD.

Mortality Rate and Risk Factor of Acute Kidney Injury (AKI)

Acute kidney injury AKI is linked with an increased risk of mortality in cardiovascular disease, acute myocardial infarction, and heart failure. It most commonly leads to the progression of chronic kidney disease CKD.

A study by the National Institute of Health (NIH) explored death rates linked to stage 3 acute kidney injury (AKI) treated with renal replacement therapy (RRT). The researchers reviewed the medical records of 1,000 stage 3 AKI patients from various hospitals between 2015 and 2018.

Data were gathered from electronic health records, tracking patient outcomes from the onset of AKI until recovery or death. The study also looked at patients' demographics, other health conditions, and the type of RRT used (hemodialysis, peritoneal dialysis, or continuous renal replacement therapy).

The National Institute of Health reported that mortality rates for patients receiving RRT in stage 3 AKI varied from 44% to 52%. These rates were influenced by factors like existing health issues (e.g., sepsis, heart failure) and the type of AKI (prerenal, intrinsic, or postrenal).

The study highlighted the importance of timely treatment and selecting the right therapy to improve outcomes in such critical cases.

It also highlighted the results of hospitalised Medicare patients for two years after discharge. It found that those who had acute kidney injury were 13 times more likely to develop end-stage kidney disease (ESRD) if they didn't already have chronic kidney problems.

For patients who had both acute kidney injury and chronic kidney disease, the risk of developing end-stage kidney disease was 40 times higher. Another research published in the Clinical Journal of the American Society of Nephrology also concluded that over 1 in 4 patients with acute kidney injury (AKI) died within a year of being hospitalised.

7. Patient Stories and Case Studies

Real-Life Patient Testimonials

In severe cases, AKI also affects the physical and psychological well-being of patients. Real-life stories show the various conditions of people suffering from a particular disease before, during, and after diagnosis and treatment.

One of the patients who had a severe infection that caused AKI highlighted its symptoms of tiredness, swelling, and low urine output. She also added that she felt fear and anxiety but also relief after successful treatment of AKI when her kidneys were restored without dialysis.

Similarly, another patient described his experience of developing AKI due to the intake of nephrotoxic drugs. He added that, besides experiencing symptoms of anxiety and a fear of permanent kidney damage, the impact was as much emotional as it was physical. However, with proper management and treatment, he could recover completely.

These testimonials add realism to the problems linked to AKI and to the patients' spirit, hope, and relief when the condition is well managed.

Case Studies Having Diverse Outcomes

There are also other cases of AKI with diverse outcomes. These cases with diverse outcomes show the complete recovery of patients suffering from acute kidney injury (AKI) with different comorbidities.

In a recent case, a 60-year-old man with a history of hypertension experienced AKI after dehydration in heat resulting from a heatwave. The patient was treated with IV rehydration drips and discontinuation of the ACE inhibitors. The patient was able to make a complete recovery.

These case reports highlight successful renal recovery and the progression to chronic renal disease. These studies support patient-centred care, particularly regarding the roles of pre-existing conditions and the early management of initial symptoms in determining positive outcomes.

Lessons Learned from Patient Experiences

The above case studies and patient testimonials provide valuable lessons about managing acute kidney injury (AKI). The practical strategies for AKI management include

Early Detection: Observing symptoms like fatigue, swelling, and changes in urine output requires early medical evaluation for timely treatment.
Timely Intervention: After diagnosis, the condition requires immediate treatment. The immediate intervention involves fluid restriction, medication, or dialysis, depending on the severity of the disease. It plays a crucial role in recovery.
Emotional and Psychological Support: AKI does not cause physical damage to the kidneys but also affects emotions and disrupts one mentally. Proper counselling from physicians and support groups helps individuals cope with stress and provides a faster recovery.

8. Frequently Asked Questions

How can dehydration cause acute kidney injury?

Dehydration can cause acute kidney injury due to decreased blood flow. It hurts the kidneys because it does not allow them to remove waste products from the body. When the body fluid content decreases, blood volume decreases, which results in lower blood pressure, thereby decreasing the kidney's blood supply. It reduces oxygen supply to the kidneys and results in Acute Kidney Injury.

How does heart failure cause acute kidney injury?

In heart failure, the heart fails to pump blood to the various body organs, affecting other organs, such as kidneys. It causes reduced blood flow to the kidneys because each contraction decreases blood output and less oxygen.

Inadequate blood flow decreases filtration and waste removal, damaging kidney tissue and resulting in Acute Kidney Injury (AKI). In other words, the failing heart cannot generate sufficient pressure to support the normal functioning of the kidneys.

How does hypovolemia cause acute kidney injury?

Hypovolemia is a condition in which a patient experiences a significant amount of blood loss. Any disease or illness can cause it, and it causes decreased fluid levels. The kidneys need proper blood circulation to filter waste products.

When blood volume decreases, the kidneys fail to get the blood supply they require, which affects their average working ability and damages the kidney tissues. Hypovolemia induces AKI due to the lack of blood supply that the kidneys need to ensure their normal functioning.

How does sepsis cause acute kidney injury?

Sepsis results in systemic inflammation throughout the body and, as such, causes inflammation within the kidneys. The body's immune response to the infection results in the widening of blood vessels, which decreases blood pressure and, thus, reduces the blood supply of the kidneys.

In addition, toxins produced in sepsis can also cause direct tissue damage to the kidney cells. Inflammation, low blood pressure, and cellular damage all together lead to AKI in many cases.

What causes intrarenal acute kidney injury?

Intrarenal AKI occurs when the kidney tissue's function and structure are disrupted. The common causes of intrarenal acute kidney injury include:

Glomerulonephritis: It causes swelling and inflammation in blood-filtering kidney structures called glomerulus.

Acute tubular necrosis (ATN): A condition in which the kidney tubules are injured from toxins or occasions due to decreased blood flow.

Vascular damage: Other diseases, such as vasculitis, affect the blood vessels of the kidneys. These conditions reduce the kidneys' filter capacity and reduce kidney function.

What causes postrenal acute kidney injury?

Postrenal AKI develops due to blockage in the urinary system. This blockage increases the pressure on the kidneys, which results in improper blood filtration. The common causes of postrenal acute kidney injury include:

Kidney stones: Calcified deposits result in stone formation that block the renal tract.

Tumours: The malignant growths form in the urinary tract and cause urine obstruction.

Enlarged prostate: In males, the prostate gland compresses the urethral passage and bladder, affecting urine flow. These obstructions also increase pressure within the kidneys, resulting in tissue inflammation and acute kidney injury.

What causes prerenal acute kidney injury?

Prerenal acute kidney injury implies pathophysiological processes, which result in a decreased amount of blood flow toward the kidney. It may caused by the following conditions:

Dehydration:Dehydration results in a reduction in blood volume and causes prerenal acute kidney injury.
Heart failure: Reduced CO leads to cardiovascular diseases (CVD) and heart failure.
Severe bleeding: People suffering from hypovolemia due to haemorrhage (severe bleeding) tend to have poor perfusion to the kidneys. These factors also limit the oxygen and nutrient supply to the kidneys and bind during renal damage

Can acute kidney damage be reversed?

Yes, acute kidney damage is reversible and requires immediate treatment if the injury is diagnosed early. Renal recovery depends on early interventions like rehydration solutions, addressing the source of infection, or unblocking blood flow to organs like sepsis.

However, ignorance of this damage or severity could result in chronic kidney disease (CKD). The recovery of renal patients depends on the severity and early diagnosis of acute kidney injury.

Can alcohol cause acute kidney injury?

Excess alcohol consumption interferes with the electrolyte balance and leads to dehydration, which may result in AKI. Alcohol is a diuretic that increases urine output and, in its excess intake, leads to fluid loss and imbalance of body fluid.

Excessive intake of alcohol also damages the liver, and liver disease has an impact on the kidney as it reduces blood circulation and may cause sepsis and other conditions resulting in AKI.

Do you need dialysis for acute kidney failure?

Acute kidney injury may require dialysis when kidneys cannot cleanse waste substances on their own. Dialysis acts as an artificial kidney that performs its function outside the body. The purpose of the process is to cleanse the blood from toxins and get rid of excess fluid. This is usually a short-term measure while the kidneys are being healed, but some people need prolonged dialysis due to severe damage.

Is acute kidney injury the same as kidney failure?

No, acute kidney injury (AKI) and kidney failure are not synonymous. AKI describes a situation where kidney function is reduced for at least 48 hours but is reversible when the basics have been met.

However, chronic kidney disease or kidney failure (also called end-stage renal disease, ESRD) is a long-term pathology when the kidneys are unable to work anymore, need dialysis on reguler basis or a kidney transplant. AKI can progress to kidney failure if not treated, but stages of kidney disease separate both.

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