Acute kidney injury: when the kidneys stop working suddenly
Dr. Joan J. Morales Lappot, MD3 min read · Leer en español
In briefAcute kidney injury (AKI) is a sudden drop in kidney function over hours or days. It sounds alarming, and it should be taken seriously, but many people recover most or all of their kidney function when the cause is found and treated early.
Common causes
- Not enough blood flow to the kidneys: dehydration, vomiting, diarrhea, bleeding, or very low blood pressure
- Medicines: anti-inflammatory pain relievers, some antibiotics, contrast dye, and combinations of blood pressure pills during an illness
- Serious infection (sepsis)
- A blockage of urine, such as an enlarged prostate or stones in both kidneys
- Muscle breakdown after extreme exercise, heat or a fall
How it is found
AKI often causes no symptoms at first. It is usually discovered when creatinine rises on a blood test. Some people notice less urine, swelling, nausea, confusion or unusual tiredness. Doctors look at the urine, the medicine list and often a kidney ultrasound to find the cause.
- You are making very little or no urine
- You have new swelling with shortness of breath
- You are confused or very drowsy
- You cannot keep fluids down for more than a day
Treatment and recovery
Treatment means fixing the cause: fluids when you are dry, stopping the medicine that is hurting the kidneys, relieving a blockage or treating an infection. A few people need temporary dialysis while the kidneys heal. After AKI, follow-up matters, because one episode raises the risk of chronic kidney disease later. I like to recheck labs and review medicines once you are home.