The silent crisis: Examining acute kidney injury

March 25, 2022
healthcaretoday, kidney health, acute kidney injury, kidney awareness, health education, Prevent AKI, kidney function, Chronic illness, Public health, kidney disease, health tips, kidney care, nutrition, hydration, Dr Lim Soo Kun, Astellas Pharma,
​​Kidneys, each roughly the size of a fist, are vital organs located deep within the abdomen, nestled beneath the rib cage. Their primary functions include filtering toxins and excess water from the blood, regulating blood pressure, producing red blood cells, and maintaining bone health. Despite their crucial roles, many people remain unaware of the significant impact kidney health has on overall well-being.

The kidneys play a critical role in controlling the levels of various minerals and molecules in the bloodstream, including sodium and potassium. They also help maintain the body’s acid-base balance, ensuring that blood acidity remains within a healthy range. Every day, these remarkable organs meticulously regulate the salt and water content in the body, which is vital for maintaining stable blood pressure.

Acute kidney injury: A growing concern
Acute kidney injury (AKI) is a sudden and dramatic loss of kidney function that can affect anyone, regardless of age or health status. This condition can develop rapidly, often within a matter of days. While the kidneys have the potential to recover almost completely from acute kidney failure, urgent treatment, including dialysis, may be necessary during the recovery process.

"Early detection of acute kidney injury is crucial. If AKI is identified before complete kidney failure occurs, timely treatment can prevent further deterioration and facilitate recovery. However, in high-risk situations, simple interventions may not suffice to avert kidney problems," explains Associate Professor Dr Lim Soo Kun (pix), Consultant Nephrologist and Head of the Renal Division, Department of Medicine, University of Malaya during a hybrid session entitled "Bridge the knowledge gap to better kidney care". 

Causes of acute kidney injury
Several factors can lead to acute kidney injury, including:
  • Sudden drop in blood flow: A serious reduction in blood flow to the kidneys can compromise their function.
  • Toxic damage: Certain medications, poisons, or infections can damage kidney tissue.
  • Obstruction: A sudden blockage that prevents urine from flowing out of the kidneys can lead to AKI.

Symptoms of acute kidney injury
Recognizing the symptoms of acute kidney injury is essential for prompt treatment. Common signs include:
  • Reduced urine output: Passing little or no urine can indicate kidney dysfunction.
  • Swelling: Fluid retention, particularly in the legs and feet, is a common symptom.
  • Loss of appetite: A decreased desire to eat may accompany other symptoms.
  • Nausea and vomiting: Digestive disturbances can occur with AKI.
  • Cognitive changes: Feelings of confusion, anxiety, restlessness, or excessive sleepiness may signal kidney issues.

The prevalence of acute kidney injury
In developed countries, acute kidney injury is often observed in hospital settings. Research indicates that between 5% to 20% of critically ill patients in intensive care units experience episodes of AKI during their treatment. The development of AKI can significantly worsen the outcomes of various illnesses, highlighting the need for increased awareness among healthcare professionals. Additionally, there are critical opportunities for prevention, particularly through careful management of prescription medications for elderly patients.

Conversely, in developing regions, the pattern of acute kidney injury differs. Many cases arise from infections and severe dehydration, often exacerbated by conditions such as gastroenteritis and malaria. Victims of natural disasters, such as earthquakes, are also at risk, as crush injuries can lead to acute kidney failure.

Education as a preventive measure
Preventing acute kidney injury requires community education and awareness. By informing local populations about the importance of hydration, recognizing early warning signs, and understanding when to seek medical intervention, many cases of AKI can be avoided. Healthcare workers in these communities play a pivotal role in disseminating knowledge and promoting preventive practices.

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