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Preface and Contents

Acute Kidney Injury

Causes and Symptoms

What is Acute Kidney Injury (AKI)?

In acute kidney injury (previously acute renal failure) reduction or loss of kidney functions occur within a short period (over hours, days or weeks) and is temporary, and usually reversible.

What causes acute kidney injury?

There are many causes of AKI. Common causes include:

  1. Reduced blood supply to the kidneys: severe dehydration due to diarrhea, blood loss, burns or fall in blood pressure.
  2. Severe infection, serious illness or after a major operation.
  3. Sudden blockage of the passage of urine : Kidney stones is the most common cause of urinary tract obstructions.
  4. Other causes: Falciparum malaria, leptospirosis, snake bite, certain kidney diseases, pregnancy, complications and side effects of some medications (NSAIDs, aminoglycosides, radio contrast, certain herbal concoctions.

Symptoms of acute kidney injury

In AKI, due to the sudden interruption in kidney function and rapid accumulation of waste products and disturbances in fluid and electrolyte balance, the patient develops early and significant symptoms.

The type of symptoms and their severity differ from patient to patient. These include:

  1. Symptoms due to underlying condition (diarrhea, blood loss, fever, chills, etc.) causing kidney failure;
  2. Decreased urine output (urine output may remain normal in a few patients).
  3. Swelling of ankles or feet and weight gain due to fluid retention.
  4. Loss of appetite, nausea, vomiting, hiccups, fatigue, lethargy and confusion.
  5. Severe and life threatening symptoms such as breathlessness, chest pain, convulsions or coma, vomiting of blood and abnormal heart rhythm due to high blood potassium levels.
  6. In the early stage of acute kidney failure some patients are symptom- free and the disease is detected incidentally when blood tests are done for other reasons.
Symptoms of acute kidney failure are due to both underlying causes and severe kidney problems.