Acute kidney injury occurs when the kidney function gets worse over a period of days or weeks. This is different to chronic kidney disease (CKD), where the kidney function may change over months or years. It is not caused by physical injury to the kidneys.
AKI is quite common, however the people most likely to get it are those with abnormal kidneys to start with - such as those with chronic kidney disease (CKD). Not everyone with CKD will have an episode of AKI, but it is good to be aware of what to look out for so that if one does occur it can be detected early and treated effectively.
If you wish to know more about Acute Kidney Injury then you can download our Understanding Acute Kidney Injury leaflet
We also have a patient information leaflet made in collaboration with the Renal Association that gives some facts about your kidneys and AKI. Download Acute Kidney Injury - Patient Information
or if you'd like to order a hard copy please contact us.
Many different conditions can cause AKI. In someone with CKD the most common causes are infection and dehydration.
AKI can also occur after an operation, or indeed after any illness severe enough to require hospital treatment. Therefore, if you have CKD it is important that doctors in hospital know this so they can take action to reduce the risk. This might mean avoiding certain types of treatment drugs or being put on an intravenous drip to prevent dehydration.
- High temperature,
- feeling sweaty,
- aches and pains in the muscles
If the infection is in the urine you may have to pass urine more often than usual and this may be painful. Dehydration most often occurs if there is vomiting or diarrhoea - but is worse if both are present.
Chances of getting AKI vary, it is best to be checked to make sure you don't have AKI if;
- You have CKD,
- You have a fever,
- You can't drink fluid for 24-28 hours,
- And are not passing much urine. A sign of severe AKI is not passing urine for more than 24 hours.
If you have CKD and have an episode of vomiting or diarrhoea, you may be able to stop yourself getting dehydrated by drinking extra fluids.
If you can spot the warning signs early and get prompt treatment by contacting your doctors' surgery you may be able to prevent AKI.
Acute kidney injury may also be more common when people are taking medications to lower blood pressure or treat heart conditions such as;
- Ace inhibitors (ACEI),
- Angiotensin receptor blockers (ARB),
- Diuretics (Water tablets).
You should be advised to stop or reduce the dose of these tablets in these circumstances and, if you're not sure, contact the medical professional managing your care. This is sometimes called 'sick day rules', and you may be given a card to advise you what to do.
AKI is normally diagnosed by a blood test to measure the level of creatinine in the blood. If the creatinine level has doubles, then there is severe AKI and urgent treatment is normally necessary. If the creatinine level has gone up by a lesser amount (e.g. 30%), then there may need to be follow up checks in the next few days. However, this is less of an emergency and may be managed in primary care with increased fluid intake and an adjustment of medication.
Treatment for AKI depends on the cause.
The most common cause of AKI is a combination of infection and dehydration, treatment often involves antibiotics (if the infection is
thought to be related to a bacterium), and giving fluids into a vein through a drip. In less severe cases it may be possible to drink extra fluid rather than have a drip.
Young people and children
We have a couple of leaflets for young people and children with AKI:-
- Young people: keeping your kidneys safe - information on what you can do to avoid developing AKI if you are taking medicines that reduce how well your kidneys work.
- How to keep your child's kidneys safe - this leaflet is for parents / carers of children who are taking medicines that may reduce how well the kidneys work, particularly if your child is dehydrated.