Acute Kidney Injury
(AKI; Acute Kidney Failure; Acute Renal Failure; Acute Renal Insufficiency)
Acute kidney injury (AKI) is the sudden loss of kidney function. Kidneys clean waste products from the blood and maintain fluid levels in the body. Problems can happen:
- Before blood enters the kidneys
- Inside the kidneys (most common)
- When urine leaves the kidneys and moves toward the bladder
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AKI has many causes:
AKI is most common in older adults. Your chances are also higher if you have:
- High blood pressure
- Kidney, liver, or heart disease
- Bleeding from the stomach or intestines
- Taken certain medicines
- Used illegal drugs
- Problems after surgery or a hospital stay
- Overused certain nonsteroidal anti-inflammatory drugs (NSAIDs)
- Some blood pressure or heart medicine when dehydration is also present
- Blockages, which can happen with benign prostatic hyperplasia or a bladder tumor
Most people do not have symptoms. In those that have them, AKI may cause:
- Lower or higher amounts of urine than normal
- Dark or red urine
- Nausea or vomiting
- Muscle weakness
- Muscle cramps
- Lack of hunger
- Weight gain
The doctor will ask about symptoms and past health. Blood and urine tests will be done to measure levels of toxins and proteins. It will show how well the kidneys are working. Images of the kidneys may be taken with:
Care depends on the cause of AKI and how serious it is. The goal is to manage the cause and support the kidneys until they can work again. The kidneys may be able to recover normal function once they have had a chance to rest. Care may involve:
- Stopping or changing medicines causing harm to your kidneys
- Controlling blood pressure and diabetes
- Avoiding medicine that could be harmful such as NSAIDs common in over-the-counter pain medicine
- Limiting salt and protein in diet
- IV fluids
- Dialysis—a machine works for your kidneys by filtering your blood
- Caring for problems such as kidney stones or infections
Some AKIs can cause permanent severe damage to kidneys. Long term dialysis or a kidney transplant may be needed.
Most AKI can not be prevented.
National Institute of Diabetes and Digestive and Kidney Diseases
National Kidney Foundation
The Kidney Foundation of Canada
Acute kidney injury. EBSCO DynaMed website. Available at: https://www.dynamed.com/approach-to/acute-kidney-injury-approach-to-the-patient. Accessed September 13, 2020.
Acute kidney injury (AKI). Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/genitourinary-disorders/acute-kidney-injury/acute-kidney-injury-aki. Accessed September 13, 2020.
Kidney failure. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure. Accessed September 13, 2020.
Rahman M, Shad F, Smith MC. Acute kidney injury: a guide to diagnosis and management. Am Fam Physician. 2012;86(7):631-639.
Last reviewed September 2020 by EBSCO Medical Review Board Last Updated: 9/13/2020