Understanding Acute Kidney Injury (AKI): When Your Kidneys Suddenly Struggle


 

Understanding Acute Kidney Injury (AKI): When Your Kidneys Suddenly Struggle

By Dr. Debabrata Mukherjee
Senior Director – Renal Sciences, Medanta The Medicity, Gurugram

What is Acute Kidney Injury (AKI)?

Acute Kidney Injury, or AKI, refers to a sudden and rapid decline in kidney function, which can occur over hours or days. In AKI, the kidneys lose their ability to filter waste products, balance fluids, and regulate electrolytes — essential functions for life.

This condition requires prompt diagnosis and treatment because, if left untreated, it can lead to serious complications or even become life-threatening.

Why Does AKI Happen?

AKI can be broadly categorized into three major types, depending on the underlying cause:

🩸 1. Prerenal AKI: Decreased Blood Flow to the Kidneys

This is the most common form and occurs due to reduced blood supply to the kidneys, often without direct kidney damage.

Common causes include:

  • Severe dehydration (hypovolemia)

  • Major blood loss (hemorrhage)

  • Heart failure

  • Sepsis

  • Liver failure

🛑 Key Point: The kidneys themselves are initially healthy, but lack of blood flow impairs their function. If caught early, prerenal AKI is often reversible.

⚠️ 2. Intrinsic (Intrarenal) AKI: Damage Within the Kidneys

Here, the problem lies within the kidney tissue itself, often due to injury or disease affecting the blood vessels, glomeruli, tubules, or interstitium.

Common causes include:

  • Acute tubular necrosis (due to ischemia or toxins)

  • Inflammation (e.g., glomerulonephritis)

  • Drug toxicity (certain antibiotics, NSAIDs, contrast agents)

  • Infections

🛑 Key Point: Intrinsic AKI requires more intensive management and may take longer to resolve.

🚫 3. Postrenal AKI: Obstruction of Urine Outflow

In postrenal AKI, urine flow is blocked after it leaves the kidneys. This causes pressure to build up in the kidneys, leading to functional decline.

Common causes include:

  • Kidney stones

  • Enlarged prostate (BPH)

  • Tumors (in or near urinary tract)

  • Surgical complications or scarring

🛑 Key Point: Timely removal of the obstruction can often restore kidney function.

Symptoms of AKI: How Do You Know Something’s Wrong?

AKI can be silent in early stages, but common signs and symptoms may include:

  • Decreased urine output

  • Swelling in legs, ankles, or around the eyes

  • Fatigue or weakness

  • Nausea and vomiting

  • Shortness of breath

  • Confusion or drowsiness

  • Thirst, dry mouth

  • Irregular heartbeat (due to electrolyte imbalance)

⚠️ Important: AKI is often detected through blood tests (e.g., elevated creatinine, urea) and urine analysis — not just symptoms.

Diagnosis & Investigations

At Medanta, we use a comprehensive diagnostic approach, including:

  • Blood tests (serum creatinine, urea, electrolytes)

  • Urine analysis

  • Kidney ultrasound

  • Imaging (to rule out obstruction)

  • In selected cases, renal biopsy

Treatment Approach of Dr. Mukherjee 

Management of AKI depends on the underlying cause, the severity of injury, and associated complications.

we focus on:

✅ Restoring blood flow and hydration in prerenal AKI
✅ Removing toxins and managing inflammation in intrinsic AKI
✅ Relieving urinary obstruction in postrenal AKI
✅ Avoiding further kidney damage from medications or contrast dyes
✅ Supporting the patient with dialysis if needed, while monitoring for recovery

Can AKI Be Prevented?

While not all cases are preventable, early detection and intervention are key. Here’s how to reduce your risk:

  • Stay hydrated, especially during illness or heat

  • Manage chronic conditions like diabetes and hypertension

  • Avoid overuse of painkillers (NSAIDs) and unnecessary antibiotics

  • Be cautious with contrast scans if you have kidney disease

  • Monitor kidney function if hospitalized or undergoing major surgery

When to See a Nephrologist

If you experience symptoms of kidney dysfunction or have a high-risk condition, consult a nephrologist promptly. At Medanta, we provide comprehensive, personalized care for all forms of kidney disease — acute or chronic.

Conclusion

Acute Kidney Injury is a medical emergency — but with timely care, many patients recover fully. Awareness, early diagnosis, and expert management can make all the difference.

For expert consultation and advanced kidney care, you can connect with me at Medanta The Medicity.

Dr. Debabrata Mukherjee
Senior Director – Renal Sciences
Medanta – The Medicity, Gurugram

📞8130060240

https://www.drmukherjeenephrologist.com

https://www.instagram.com/dr_mukherjee_nephrologist/ 

Location: Medanta- The Medicity, CH Baktawar Singh Rd, Medicity, Islampur Colony, Sector 38, Gurugram, Haryana 122001, India

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