Language
Country/Area
No result found
Sudden Decline in Kidney Function: Do You Know the Potential Causes of Acute Kidney Injury?
Acute kidney injury (AKI), formerly known as acute renal failure, is a rapidly progressive decline in kidney function over seven days, usually reflected by an increase in serum creatinine or a decrease in urine output. According to different causes, AKI can be divided into pronephric (due to reduced blood supply to the kidneys), endorenal (due to damage to the kidney itself), and metanephric (due to urinary flow disorder). Understanding these potential causes is critical to prompt detection and treatment of this disease.
Potential causes of acute kidney injury can include dehydration, heart failure, certain medications, and diseases of the kidneys themselves.
Causes of acute kidney injury
Causes of pronephros
Pronephric acute kidney injury is mainly due to insufficient effective blood flow leading to a decrease in glomerular filtration rate (GFR). This usually occurs due to loss of blood volume, such as dehydration or heavy bleeding. Hypotension, heart failure, and hepatorenal syndrome are common pronephric factors. In addition, certain drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs) and ACE inhibitors may also cause renal vasoconstriction, exacerbating this condition.
Inner renal causes
Intrarenal acute kidney injury refers to diseases that directly damage kidney tissue, which may involve structures such as renal tubules, glomeruli, or renal interstitium. Common causes include acute tubular necrosis, tubulointerstitial nephritis, and kidney injury caused by medications, such as certain antibiotics and chemotherapy drugs.
Metanephric causes
Metanephric acute kidney injury is usually caused by obstruction of urine output, which may be related to benign prostatic hyperplasia, kidney stones, or tumors. Blockage in the kidneys may lead to impaired kidney function, and timely relief of the blockage is critical to restoring kidney function.
Diagnosis and testing
The diagnosis of acute kidney injury relies on clinical signs and laboratory tests. The main diagnostic criteria include a dramatic increase in serum creatinine and a significant decrease in urine output. Medical staff may also perform urine microscopy and kidney ultrasound to further determine the cause. Renal biopsy may be necessary in cases of suspected intrarenal AKI.
More than 50% of patients in the ICU may suffer acute kidney injury, making early diagnosis even more urgent.
Symptoms of acute kidney injury
The clinical manifestations of acute kidney injury often depend on its underlying cause. Accumulated urea and other nitrogen metabolites may cause symptoms such as fatigue, loss of appetite, nausea, and headaches. Hyperkalemia can cause heart abnormalities and can be life-threatening.
Treatment methods
Management of acute kidney injury focuses on identifying and treating the underlying cause. Specific measures include adding fluids to improve blood flow to the kidneys, using diuretics to help reduce edema, and avoiding toxic medications such as NSAIDs. For metanephric acute kidney injury caused by urinary obstruction, intervention is required through catheterization or nephrostomy.
Depending on the cause, some cases may require dialysis or renal replacement therapy.
Prognosis and complications
Mortality from acute kidney injury can be as high as 20%, especially among patients in intensive care units. In the long term, people who have experienced AKI are at increased risk of developing chronic kidney disease, and there are also many patients who fail to fully recover kidney function after treatment.
Conclusion
After understanding the causes, symptoms and treatment of acute kidney injury, we can’t help but think about what factors in our daily lives may potentially affect our kidney function?
