Acute Kidney Injury
Introduction[edit | edit source]
Acute kidney injury (AKI):
- A sudden (within hours) decline in kidney function, which includes both injury (structural damage) and impairment (loss of function)[1].
- Often referred to as acute renal failure (ARF), is a sudden episode of kidney damage or failure that occurs within a few hours or days [2]and is indicated by a sharp rise in serum creatinine, a decline in urine output, or both.
- AKI is known to occur in between 10% and 15% of hospitalized patients, with more than 50% of patients need intensive care[3].
- AKI is distinct from chronic kidney disease, which causes the kidneys to slowly lose function over time[4].
Epidemiology[edit | edit source]
There are significant disparities in the incidence and etiology of AKI between developing and industrialized nations[5].
In developing nations' cities, the most prevalent causes of AKI are hospital acquired (renal ischaemia, sepsis, and nephrotoxic medications), but in rural regions, it is more usually a result of community acquired illness (diarrhoea, dehydration, viral diseases, animal venoms, and so on)[6].
The incidence of AKI is rising in industrialized nations. It is believed to occur up to 15% of the time in hospital inpatients, and it is more prevalent in critically sick patients, where it is anticipated to occur up to 60% of the time[1].
Etiology[edit | edit source]
The causes of acute kidney injury are classified as:
- Prerenal
- Intrinsic renal
- Postrenal
Prerenal AKI occurs due to inadequate blood flow to the kidney. The main causes are:
- Extracellular fluid volume depletion (caused, for example, by insufficient fluid intake, diarrheal disease, and sepsis)
- Decompensated liver disease (cirrhosis)
- Cardiovascular illness (such as heart failure and cardiogenic shock)
Intrinsic Renal causes of AKI involve intrinsic kidney disease or damage. Blood arteries, glomeruli, tubules, and the interstitium can all be affected. The most frequent reasons include:
- Acute glomerulonephritis
- Acute tubular necrosis
- Nephrotoxins (including over-the-counter and prescription medications)
Postrenal AKI (obstructive nephropathy) is due obstruction in the voiding and collecting sections of the urinary system such as Bladder outlet blockage brought on by an enlarged prostate[7].
References[edit | edit source]
- ↑ 1.0 1.1 Makris K, Spanou L. Acute kidney injury: definition, pathophysiology and clinical phenotypes. The clinical biochemist reviews. 2016 May;37(2):85.
- ↑ Acute Kidney Injury (AKI). Available: https://www.kidney.org/atoz/content/AcuteKidneyInjury (accessed 22.04.2023)
- ↑ Ronco C, Bellomo R, Kellum JA. Acute kidney injury. The Lancet. 2019 Nov 23;394(10212):1949-64.
- ↑ Acute kidney injury. Available: https://www.nhs.uk/conditions/acute-kidney-injury/#:~:text=Acute%20kidney%20injury%20(AKI)%20is,as%20the%20name%20might%20suggest. (accessed 22.04.2023)
- ↑ Lameire NH, Bagga A, Cruz D, De Maeseneer J, Endre Z, Kellum JA, Liu KD, Mehta RL, Pannu N, Van Biesen W, Vanholder R. Acute kidney injury: an increasing global concern. The Lancet. 2013 Jul 13;382(9887):170-9.
- ↑ Prakash J, Singh TB, Ghosh B, Malhotra V, Rathore SS, Vohra R, et al. Changing epidemiology of community-acquired acute kidney injury in developing countries: analysis of 2405 cases in 26 years from eastern India. Clin Kidney J. 2013;6:150–5.
- ↑ Acute Kidney Injury (AKI) (Acute Renal Failure). Available: https://www.msdmanuals.com/professional/genitourinary-disorders/acute-kidney-injury/acute-kidney-injury-aki#top (accessed 22.04.2023)
