Acute Kidney Injury (AKI): Understanding Causes, Symptoms, and Treatments

You may be at higher risk of developing Acute Kidney Injury (AKI) if you:

Being aware of these factors can help you take precautions to lower your risk.

Develops when there is a sudden and severe reduction in blood pressure or an interruption in blood flow to the kidneys as a result of serious injury or sickness. It is the most prevalent type of AKI, resulting from insufficient renal blood flow rather than kidney injury. Due to a lack of perfusion, the kidneys are unable to efficiently filter waste from the blood.

This form is characterised by direct injury to kidney tissues caused by inflammation, toxins, medications, infection, or a decreased blood supply. The most common causes include acute tubular necrosis (kidney damage caused by reduced blood flow or toxins), glomerulonephritis (swelling of the kidney’s filters, affecting kidney function), and vascular disorders such as thrombotic microangiopathies (conditions where clots form in small vessels, harming organs). This injury causes more severe failure in renal filtration and regulatory functions.

This kind of AKI develops when there is a blockage in the urinary tract below the kidneys, resulting in inadequate urine outflow and kidney injury. Kidney stones, tumors, and an enlarged prostate gland are common causes of obstructive AKI because they constrict the routes through which urine passes. The obstruction can cause pressure to build up backwards into the kidneys, limiting their function and even causing permanent kidney damage if not treated swiftly.

If you or a loved one is suffering AKI-related symptoms, early detection and treatment can make all the difference. At Nuffield Kidney & Dialysis, we understand how stressful it can be to face a potential kidney problem. Our professional team is ready to provide comprehensive care and answer any of your inquiries. Contact us immediately to schedule a consultation; your kidney health is our top priority.

This category includes conditions that reduce blood supply to the kidneys, potentially leading to kidney damage:

• Heart Failure: Impaired cardiac function reduces blood flow to various organs, including the kidneys.
• Dehydration: Insufficient fluid intake or excessive fluid loss can decrease blood volume and kidney perfusion.
• Liver Disease and Cirrhosis:These conditions can alter blood flow dynamics, affecting kidney function.
• Sepsis:Severe infections can lead to reduced blood pressure and kidney perfusion.
• Blood Clots:Thrombosis can obstruct blood flow to the kidneys.
• Vasculitis:Inflammation of blood vessels can restrict blood supply to the kidneys.
• Anaphylaxis:Severe allergic reactions can cause a drop in blood pressure, affecting kidney perfusion.
• Cholesterol Deposits:These can block blood flow within the kidneys.
• Scleroderma:This rare disease can affect blood vessels, potentially impacting kidney blood flow.
• Thrombotic Thrombocytopenic Purpura:This blood disorder can affect small blood vessels, including those in the kidneys.
• Severe Burns:Can lead to significant fluid loss and reduced kidney perfusion.
• Liver Failure:Can cause alterations in blood flow and kidney function.
• Decompensated Liver Disease:Advanced liver disease can significantly impact kidney blood flow.

This category includes conditions that directly harm kidney tissue:

• Drugs and Toxins: Certain medications and substances can be nephrotoxic, directly damaging kidney cells.
• Glomerulonephritis:Inflammation of the kidney’s filtering units can cause acute damage.
• Lupus: This autoimmune disease can cause inflammation and damage to various organs, including the kidneys.
• Acute Tubular Necrosis: Damage to kidney tubules, often due to lack of oxygen or exposure to toxins.
• Interstitial Nephritis:Inflammation of the spaces between kidney tubules.
• Infections: Various infections can lead to kidney inflammation and damage.
• Rhabdomyolysis: Breakdown of muscle tissue releases toxins that can damage the kidneys.
• Tumor Lysis Syndrome: Rapid breakdown of cancer cells releases substances that can injure the kidneys.
• Diabetes: Poorly managed diabetes can lead to kidney damage over time..
• Myeloma: This blood cancer can cause kidney damage through various mechanisms.
• Alcohol: Excessive alcohol consumption can directly damage kidney tissue.

This category includes conditions that obstruct the flow of urine, potentially leading to kidney damage:

• Kidney Stones: Can block the urinary tract, causing urine to back up into the kidneys.
• Enlarged Prostate:Can obstruct urine flow, potentially affecting kidney function.
• Tumours in the Pelvis:Ovarian or bladder tumours can compress the ureters, obstructing urine flow.

There are several ways to treat Acute Kidney Injury (AKI). Let’s break down the options:

Each person’s treatment plan is unique. Your doctor will work with you to find the best approach for your situation. Remember, many people recover from AKI with the right care.

Choose Nuffield Kidney & Dialysis for comprehensive kidney care. Our experienced team and state-of-the-art facilities provide personalised treatment plans for acute kidney injury. Schedule a consultation today to learn how we can help you recover and improve your quality of life.

• Consultation and Diagnosis:We’ll begin with a thorough consultation to understand your medical history, symptoms, and any medications you’re taking. This may involve blood tests, urine tests, and imaging scans like ultrasound or X-ray to diagnose the specific kidney issue.
• Preparing for Treatment: Based on the diagnosis, we’ll discuss the most appropriate procedure for you. We’ll explain the process in detail, answer any questions you may have, and obtain your informed consent.
• Pre-Procedure Instructions:You may receive specific instructions regarding fasting, modifying medications, or bringing medical records to the procedure.

• A. Addressing Blood, Protein, or Electrolyte Issues:
  • Urinalysis:This simple test analyses your urine for the presence of blood, protein, or abnormal electrolyte levels.
  • Blood Tests:These tests evaluate your kidney function and electrolyte balance.
• B. Detecting and Treating Infections:
  • Urinalysis and Culture:We may test your urine for signs of infection and identify the specific bacteria involved.
  • Antibiotics:Depending on the infection type, we may prescribe antibiotics to treat it.
• C. Early Kidney Abnormality Detection:
  • Blood Tests:Evaluating your blood for markers of kidney function can detect early signs of damage.
  • Urine Tests:Analysing urine for protein or blood can also indicate potential issues.
  • Imaging Scans:Depending on the situation, we might use ultrasound, X-ray, or CT scan to visualise your kidneys.
• D. Specialised Procedures:
  • Kidney Biopsy:In some cases, we may need to extract a small tissue sample from your kidney for further analysis. This is typically an outpatient procedure with minimal discomfort.
  • Dialysis:If your kidneys are no longer functioning adequately, we offer hemodialysis (filtering blood through a machine) or peritoneal dialysis (using your abdomen as a filter) to remove waste and excess fluids.
  • Kidney Transplant:For patients with end-stage kidney disease, we provide comprehensive care before and after kidney transplant surgery.

• Recovery Instructions: Following the procedure, we’ll provide detailed instructions on managing any pain, resuming your medications, and monitoring your recovery.
• Follow-up Appointments:We’ll schedule follow-up appointments to monitor your progress, adjust medications if needed, and ensure your kidneys are functioning properly.

Remember, this is just a general overview. The specific details of your procedure will vary depending on your individual needs. We encourage you to discuss any questions or concerns you may have with your Nuffield Kidney & Dialysis doctor.

Together, we can work towards maintaining your optimal kidney health.

• Creatinine: Measures the level of creatinine, a waste product, in your blood.
• Blood Urea Nitrogen (BUN): Assesses how well your kidneys are filtering out urea nitrogen./
• Electrolytes: Checks for imbalances in sodium, potassium, and bicarbonate levels.

• Urinalysis:A sample of your urine to find clues about the cause of the injury.
• Urine Output:Measures how much urine you pass over 24 hours, indicating kidney function.

• Ultrasound and CT Scans: Visualise your kidneys to spot any abnormalities or blockages.
• Kidney Biopsy: A needle takes a small tissue sample for lab analysis. This helps identify the underlying cause.

Acute kidney injury (AKI) can have serious short-term consequences if left untreated. Understanding these risks is crucial.

• Injury to Organs: AKI can affect other vital organs like the heart and liver, leading to multi-organ failure.
• Severe Dehydration: Reduced blood flow to the kidneys can exacerbate dehydration and worsen AKI.
• Chronic Kidney Disease (CKD): Untreated AKI can lead to CKD, requiring long-term medical attention and possible dialysis.
• High Blood Pressure (Hypertension): AKI can cause fluctuations in blood pressure, posing risks to your cardiovascular health.
• Electrolyte Imbalance: Issues like hyperkalaemia (high potassium levels) can arise, affecting heart function.
• Acidosis: Metabolic acidosis may occur, leading to discomfort and potential complications.
• Cancer: AKI may complicate cancer treatments by making it harder to manage symptoms and medications.
• Heart Disease: The risk of heart disease increases due to stress on the cardiovascular system.
• Hypotension (Low Blood Pressure): Persistent low blood pressure can hamper blood flow to vital organs.

Older adults and those with chronic illnesses are at higher risk for severe complications.

Acute kidney injury (AKI) can lead to a number of serious complications. It’s important to be aware of these potential issues to ensure timely intervention and management.

• Pulmonary oedema: Excess fluid can accumulate in your lungs, causing shortness of breath.
• Oedema: Fluid retention may lead to swelling in your legs, ankles, or feet.
• Chest Pain: The lining around your heart can become inflamed, causing discomfort.
• Heart Rhythm Problems: High levels of potassium in your blood can disrupt your heart’s normal rhythm.
• Heart Failure: AKI can exacerbate existing heart failure or lead to new-onset heart failure, particularly in individuals with underlying cardiovascular disease.
• Muscle Weakness: This may result from imbalanced electrolytes.
• Paralysis: Severe cases of potassium imbalance may cause temporary paralysis.
• Hyperkalemia: High levels of potassium in the blood can lead to dangerous irregular heartbeats.
• Uremia: Elevated levels of urea and creatinine in the blood indicate poor kidney function.
• Stomach or Intestinal Issues: You might experience bleeding in the stomach or intestines, often indicated by bloody stools or vomit.
• Weakened Immune System: AKI can make you more susceptible to infections due to reduced kidney function.
• Chronic Kidney Disease: AKI can progress to chronic kidney disease, requiring long-term management.
• Diabetes: AKI can worsen existing diabetes or lead to new-onset diabetes.
• Liver Diseases: AKI can exacerbate existing liver diseases or lead to new-onset liver problems.

When AKI is not treated promptly or adequately, it can progress to Chronic Kidney Disease (CKD), a long-term illness in which kidney function diminishes over time. Chronic Kidney Disease is a major health condition that may necessitate long-term and sometimes painful treatments such as kidney dialysis or a transplant. Preventing AKI or treating it early is critical to lowering the risk of developing CKD. At Nuffield Kidney & Dialysis, we offer comprehensive care regimens that aim to monitor and maintain kidney function, thereby preventing the progression to Chronic Kidney Disease.

Treating acute kidney injury (AKI) presents several risks. It’s important to understand these risks to manage your health better.

• Medication Side Effects: Many treatments involve medications that can have side effects. Some drugs might worsen kidney function. Always inform your healthcare provider about any other medications you are taking.
• Infection Risk: Hospital stays and procedures increase the chance of infections. Proper hygiene and sterile techniques are vital. Ask about infection control measures in place to protect you.
• Fluid Imbalance:Treating AKI often involves managing your body’s fluid levels. Incorrect fluid management can lead to dehydration or fluid overload. Both are harmful and need careful monitoring.
• Nutritional Issues:Dietary changes might be recommended. However, improper nutrition can lead to deficiencies or worsen your condition. Consult a dietitian to ensure you are getting the right nutrients.
• Allergic Reactions: Some treatments may include drugs or substances that could cause allergic reactions. Make sure to report any known allergies to your healthcare team.
• Electrolyte Disturbances: AKI treatments can affect electrolytes like potassium and sodium. Mismanagement may lead to heart issues or other complications. Regular blood tests help track these levels.

We understand that the prospect of AKI treatment can be concerning, especially given the potential risks involved. It’s important to be aware of these risks, including medication side effects, infection, fluid imbalances, nutritional issues, allergic reactions, and electrolyte disturbances.

At Nuffield Kidney & Dialysis, we are committed to providing the highest quality care for patients with AKI. Our experienced team of healthcare professionals is well-versed in managing these risks and ensuring your safety throughout your treatment. We utilise advanced techniques, follow strict infection control protocols, and closely monitor your condition to minimise potential complications.

We will work with you to develop a personalised treatment plan that takes into account your unique needs and medical history. Our goal is to help you recover from AKI as quickly and safely as possible. Please don’t hesitate to ask any questions you may have about your treatment or the risks involved.

Ready to take the next step in your kidney health journey? Schedule a consultation with our expert team at Nuffield Kidney & Dialysis today.

The treatment for acute kidney injury (AKI) in Singapore can be quite expensive. Costs are influenced by the severity of the condition and the specific treatments required.

The overall cost*—depending on the length of treatment and complexity—can accumulate quickly. As a result, having adequate health insurance can help manage these expenses. Always consult with your healthcare provider and insurance company for detailed cost assessments and coverage options.

At Nuffield Kidney & Dialysis, we offer specialised care for patients experiencing AKI, providing prompt treatment to prevent long-term kidney damage.

If you or a loved one are experiencing AKI, don’t hesitate to contact Nuffield Kidney & Dialysis. Our friendly and knowledgeable staff are here to answer your questions and help you schedule an appointment. Let us be your partner in navigating kidney health, offering you the care, expertise, and support you deserve.

In Singapore, patients with acute kidney injury (AKI) can access various subsidies to help manage treatment costs.

• Government Subsidies: The Ministry of Health (MOH) provides subsidies for community haemodialysis and peritoneal dialysis services. These subsidies are designed to make treatments more affordable for those in need.
• Insurance Coverage: Many insurance plans cover AKI treatments, including dialysis and other support therapies. It’s essential to check with your insurance provider to understand your coverage options.
• Payment Methods: Most healthcare providers in Singapore accept various payment methods, making it easier for patients to manage costs. Options typically include cash, credit cards, and Medisave – a national medical savings scheme.

Having financial support can alleviate some of the stress associated with AKI treatments. Ensure you explore all available options to find the best financial support for your situation.

Kellum, John A., et al. “Acute Kidney Injury.” Nature Reviews Disease Primers, vol. 7, no. 1, July 2021, doi:10.1038/s41572-021-00284-z.

Murugan, Raghavan, and John A. Kellum. “Acute Kidney Injury: What’s the Prognosis?” Nature Reviews Nephrology, vol. 7, no. 4, Feb. 2011, pp. 209–17, doi:10.1038/nrneph.2011.13.