Acute Kidney Injury (AKI) and Chronic Kidney Disease (CKD)

Acute kidney injury (AKI), also known as acute renal failure (ARF), is a “sudden episode of kidney failure or kidney damage that happens within a few hours or a few days. AKI causes a build-up of waste products in the blood and makes it hard for the kidneys to keep the right balance of fluid in the body.” Sometimes kidneys are not able to fully recover, and people develop a condition called chronic kidney disease. 

How Does AKI Occur and What is the Treatment?

Depending on the cause of the AKI, immediate attention is needed because it can progress into chronic kidney disease (CKD) or even end stage renal disease, also known as kidney failure. AKI can have many different causes:

• Hypotension: low blood pressure
• Blood or fluid loss: usually due to bleeding or severe diarrhea
• Overuse of pain medications: ibuprofen, ketoprofen, and naproxen
• Sepsis: a life threatening infection of the blood
• Vasculitis: inflammation and scarring of the blood vessels
• Scleroderma: a group of diseases affecting the connective tissue in your organs
• “Conditions that cause inflammation or damage to the kidney tubules, to the small blood vessels in the kidneys, or to the filtering units in the kidneys (such as tubular necrosis, glomerulonephritis, vasculitis or thrombotic microangiopathy.)”

Treatment for AKI usually involves a hospital stay. Dialysis may be needed temporarily to recover kidney function. After an initial diagnosis of AKI, there is a higher risk of developing other conditions like kidney disease, stroke and heart disease. 

What are the Symptoms of Kidney Problems?

If AKI leads to chronic kidney disease, the kidneys will slowly decrease in function.

Symptoms may not be noticeable until late stage kidney disease:

• Foamy urine, or urinating more or less often than usual
• Itchy or dry skin
• Fatigue
• Nausea
• Loss of appetite

These are the symptoms of the most advanced stages Of chronic kidney disease:

• Swelling in arms, legs, ankles or feet.
• Muscle cramps and shortness of breath.
• Vomiting and trouble sleeping.

A Recent Study to Improve Kidney Function

Anyone can develop chronic kidney disease, at any age. If CKD has been caused by acute kidney injury (AKI), there are continuing research options to identify and manage this disease. A recent study found that quickly receiving intravenous (IV) fluids improved kidney function within 2 days. Critically ill patients with AKI need proper at-home follow-up care to keep creatinine levels within normal range.

Nephrotoxicity, a rapid deterioration in the kidney function due to toxic effects of medications and chemicals, can be a common concern for patients with either AKI or CKD.

Here are some medications to be aware of:

• Vancomycin and piperacillin-tazobactam
• Vancomycin and cefepime
• Vancomycin and meropenem
• Sulfonamides (co-trimoxazole)
• Aminoglycosides and penicillins
• Antiarrhythmics and loop diuretics
• Immunosuppressants

For AKI and CKD, early detection is important and begins with knowing your risk factors and any apparent symptoms.