Acute Kidney Injury 101

• Have you heard of an acute kidney injury (AKI)? 
• Acute kidney injury is a medical emergency that can change someone’s life forever. 
• Learn all about the basics of a common medical emergency. 

The kidneys are an extremely important set of organs that remove waste and excess fluid throughout the body several times a day. They do so much work in maintaining the body’s homeostasis, fluids, and function.  

But, what happens when the kidneys have a sudden injury?  

What if the kidneys suddenly do not work as well as they used to? 

What Is an AKI?

Acute kidney injury (AKI), also known as acute renal failure (ARF), occurs when there is a sudden trauma to the body can cause a build-up of waste products in the blood and fluid imbalances. Depending on the cause for AKI, AKI is often reversible.  

AKI often takes a few hours to a few days to develop and is mostly seen in people who are already hospitalized. However, without prompt treatment, AKIs can lead to chronic kidney disease (CKD) or renal failure.  

Kidneys are vital for daily function and activity. If anything happens to someone’s kidneys, their livelihood and quality of life can be significantly impaired. 

What Causes AKI?

AKI is a medical emergency often triggered by a complication of another health condition or bodily trauma.  

Common causes for AKI include: 

• Physical injury 
• Dehydration 
• Hemorrhage 
• Sepsis 
• Burns 
• Surgery 
• Anaphylaxis  
• Pregnancy 

What Are Some Risk Factors for AKI?

• Hospitalization 
• Older age 
• Pre-existing kidney conditions 
• Liver failure 
• Use of certain medications 
• Cancer 
• Diabetes 
• High blood pressure 
• Excessive alcohol intake 

Signs and Symtpoms of an AKI

Sometimes, people with an acute kidney injury have no signs or symptoms.  

Other times, common signs and symptoms include: 

• Peripheral edema 
• Fatigue 
• Confusion 
• Shortness of breath 
• Decreased urination 
• Loss of appetite 
• Nausea 
• Chest pain or pressure 

What Can I Do to Learn More About an AKI?

AKI is a serious medical emergency and can be diagnosed by clinical assessment and blood tests that examine kidney function, such as creatinine levels, glomerular filtration rate (GFR) levels, and complete blood count (CBC) levels.  

Looking at a patient’s mental state, intake and output, vital signs, and blood loss are also critical in determining if they are at risk or could have AKI. 

AKI can be indicated if any of the following are present: 

• Increase in serum creatinine by 0.3 mg/dL or more (26.5 micromoles/L or more) within 48 hours 

• Increase in serum creatinine to 1.5 times or more baseline, within the prior 7 days 

• Urine volume less than 0.5 mL/kg/h for at least 6 hours 

Common nursing interventions for patients with AKI include: 

• Restoring fluid balance  
• Preventing infection 
• Weighing the patient daily 
• Administering medications 
• Improving nutritional intake 
  

Depending on the severity of AKI, lifestyle changes might be necessary as well. AKI is often resolved within a few days of detection. Yet, in some cases, AKI can lead to chronic renal failure or death. 

What Can I Do to Learn More About an AKI?

AKI is a common medical emergency. If you work in emergency health settings, at some point, you will encounter AKI.  

Having a thorough understanding of renal health, blood work, and kidney function are essential for early detection, treatment, and management of this condition.  

Nurses are the most trusted profession for a reason. Patients often turn to nurses for medical information since there can be so many uncertainties about health care, medication, and more. 

Some ways you can raise awareness about AKI with patients include: 

• Providing educational materials on kidney health 
• Addressing any concerns about urination and bodily changes 
• Reviewing patients’ health records to note for any sudden changes in labs 
• Educating patients on red flags, such as decreased need to urinate or increased in swelling
  

Some ways you can learn more about AKI include:  

• Discussing with nursing management on any AKI and kidney health education efforts at your workplace 
• Enrolling in continuing education focusing on medical emergencies or kidney health or both 

The Bottom Line

Instances of acute kidney injury can be hard to detect, especially in patients who do not present with any symptoms, who do not have standing orders for routine bloodwork, and who do not have any pre-existing health conditions.  In patients who have existing health conditions, AKI can be overlooked and not early detected. 

As nurses, it is important to take a holistic view of each patient we care for.

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