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Acute Kidney Injury (AKI)

Date: October 2019

Review: October 2021

Ref: C-327/renal/JMcD/acute kidney v2

PDF:  Acute kidney injury AKI [pdf] 214KB

What is Acute Kidney Injury?

Acute Kidney Injury (also known as AKI) is a sudden loss in kidney function causing a build-up of toxins in the blood and problems with fluid balance.

AKI is not a physical injury and often occurs without symptoms.

AKI is detected from blood tests or from measuring how much urine you’re passing.

What do the kidneys do? 

The kidneys are an important part of the body and are involved in:

  • Removing waste products and excess fluid that is passed out as urine
  • Keeping levels of electrolytes stable
  • Making hormones that help regulate blood pressure, make red blood cells and keep bones healthy

What causes AKI?

There are a number of different causes of AKI these include:

  • Serious infection
  • Low blood pressure as a result of an illness
  • Dehydration
  • Blockages of the tubes draining the kidneys/bladder
  • Rare kidney inflammation conditions
  • Some medications

Will my kidney function recover?

In many cases the kidneys will recover quickly and return to their normal function. Often as a person’s illness improves their kidney function also improves.

If your kidney function does not improve you may need dialysis to remove the waste products and excess water your kidneys would normally remove.

 

What happens next?

The doctors and nurses will monitor your blood tests and how much urine you’re producing.

You may need a scan of your kidneys to check for any abnormalities and that they are not blocked.

The doctors and nurses will monitor your fluid balance and may need to give you fluids through a drip. You may also require a catheter to ensure accurate monitoring of what urine you’re passing.

A dipstick of your urine will be performed to check for signs of infection or kidney damage.

They will also look at what medications you’re taking and may need to stop some of them.

You may be seen by the AKI Nurse or the renal doctors.

A small number of patients with AKI will need more tests for example a kidney biopsy.

Less than 5% of patients will need dialysis.

 

Tips to maintain good kidney health

  • Maintain a healthy lifestyle
  • Stop smoking, if you need assistance with this speak to a healthcare professional who can arrange for advice and support
  • Moderate your alcohol intake (no more than 3-4 units a day for men and 2-3 units a day for woman)
  • Try to lose weight if you’re overweight or obese
  • Do regular exercise for at least 30 minutes 5 times a week
  • Restrict your salt intake and maintain a well-balanced diet
  • If you have diabetes or high blood pressure having good control of these can help stabilise your kidney function.
  • If you become unwell with vomiting or diarrhoea, fevers, sweats and shaking or aren’t passing as much urine as normal then seek advice from your GP or out of hour’s service.
  • Be aware of which of your regular medications have an impact on your
  • kidney function and when you should temporarily stop these.
  • Your doctor or nurse will document overleaf which of your medications you need to be aware of.
  • If you are coming into Hospital or having any treatments or tests inform the staff that you have had an AKI.

My Kidney Function

Creatinine is a waste product that the kidneys normally remove.

  • My usual creatinine before I came into hospital ………………………..
  • My highest creatinine during my time in hospital … ……………………
  • My creatinine today/when leaving hospital ………………………

 

Medications

In many cases of AKI we stop some of your tablets, either permanently, or for a short period of time until your kidneys have recovered.

You will be given a discharge letter with a list of the medications we want you to carry on taking.

As well as this it’s important you understand which medications have been stopped.

Medicines that were stopped in hospital:

   Name of tablet ……………………….

   Why it was stopped…………………..        

   ……………………………………..…..

   When should I restart it …………..…

   When should I avoid it in the future?

   ……………………………………..…..

    

   Name of tablet …………………….....

   Why it was stopped……………..……

    ……………………………………..….

   When should I restart it ………..……

   When should I avoid it in the future?

   ………………………………………....

For further information

  • Think Kidneys
  • www.thinkkidneys.nhs.uk/
  • The British Kidney Patient Association www.britishkidney-pa.co.uk
  • National Kidney Federation
  • www.kidney.org.uk
  • Kidney Patient Guide www.kidneypatientguide.org.uk
  • NHS Choices
  • www.nhs.uk/pathways/kidneydisease

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