Acute kidney injury or failure is caused by a sudden loss of the kidney's ability to remove toxins, excess chemicals and water.

Acute kidney injury often occurs in connection with another medical condition or event, such as extremely low blood pressure, decreased oxygen to the kidney and obstruction, trauma or infections to the kidney. It may also be a result of poor heart function, liver conditions or prostate gland enlargement. It often reverses within several weeks to months.


Signs vary from patient to patient but can include:
  • Decreased urine output 
  • Loss of appetite
  • Swelling, due to fluid retention
  • Nausea and vomiting
  • Changes in stools 
  • Fatigue or weakness
  • Changes in mood or mental status
  • Shortness of breath

Diagnosis

When your kidneys are not working correctly, waste and fluids build up in your blood. Your doctor may want to start tracking your kidney function to measure your Estimated Glomerular Filtration Rate (eGFR). The eGFR is an estimate of the amount of kidney function you have left. It is important to track your baseline eGFR and changes in this score over time. Ask your healthcare team about what is normal for you.

Treatment

Treatment is divided into hospital and post-discharge care. During hospital stay, the goal is to allow the kidneys to heal and prevent further buildup of fluids and waste products in the body. Certain foods may be restricted to keep you healthy and reduce stress on the kidneys. These foods include protein (meat, milk products, eggs), salt and potassium, which is found in some fruits and vegetables and salt substitutes. Fluids, including anything that becomes a liquid at room temperature, such as ice, Jello, yogurt and ice cream, may also be restricted.

Dialysis may be done to remove extra fluids and toxins. This procedure often makes you feel better and helps control kidney failure by removing fluid and extra electrolytes. Electrolytes are salts and minerals that affect heart function, muscle function and fluid intake and output in the body.

Both during and after your hospital stay, you will be encouraged to stay active, cough and breathe deeply to help prevent infection. Because constipation may occur due to fluid or diet restrictions, decreased activity and medicines, be sure to take a stool softener, even if constipation has not been a problem in the past.

You will need frequent outpatient follow-ups with your kidney doctor; please inform your doctor of any other scheduled tests. Due to low immunity to infection, you may need to follow special precautions, such as taking antibiotics to prevent infections.

If you are being treated for acute kidney injury, contact your doctor if there are any changes in your condition or if any of these signs get worse: 
  • Swelling in the hands, face or feet 
  • Itching of the skin
  • Nausea or vomiting
  • Loss of appetite
  • Changes in urination
  • Headache and confusion
  • Fatigue and weakness, which may be due to anemia
  • Feeling short of breath 

If the kidneys do not recover, treatment begins for chronic kidney disease.

Why seek treatment at Ohio State

Ohio State is recognized by U.S.News & World Report as one of the nation's best hospitals for urology and nephrology. Schedule an appointment with Ohio State's urology and kidney experts. Call 614-293-8155. Ohio State is a leader in vascular access, having three interventional nephrologists, physicians specializing in the maintenance of vascular access for patients undergoing dialysis. Vascular Access Centers are located at University Hospital and University Hospital East.

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