User:Mr. Ibrahem/Acute kidney injury

Acute kidney injury (AKI), previously called acute renal failure (ARF), is the sudden decrease in kidney function. Symptoms may include a decrease in urine output. Complications may include pulmonary edema, uremia, and electrolyte abnormalities such as high blood potassium and metabolic acidosis.

Causes can be divided into prerenal, intrinsic kidney, and post-renal. Prerenal causes include anything that decreases blood flow to the kidneys such as bleeding, vomiting, diarrhea, sepsis, and NSAIDs. Intrinsic kidney causes include acute tubular necrosis, interstitial nephritis, and glomerulonephritis. Post-renal causes include kidney stones, bladder cancer, and other causes of urinary obstruction. Diagnosis is based on a 50% increase in serum creatinine within 7 days, a 26.5 umol/L (0.3 mg/dL) within 2 days, or a urine output of less than 0.5 mL/kg per hour for at least six hours.

Management in part depends on the underlying cause. If the bladder is blocked, drainage is required. If a person's blood volume is low intravenous fluid are given. If the kidneys themselves are the reason, furosemide or immunosuppressants may be used. Other supportive measures such as a low potassium diet and dialysis may be required. Often it is reversible.

AKI is common, affecting up to 7% of people admitted to hospital and 30% of people admitted to ICU. In hospitalized people 21% of cases are prerenal, 69% are intrinsic kidney, and 10% are post-renal. Of the intrinsic kidney group acute tubular necrosis is the most common cause. Acute kidney injury was described as early as the Byzantine period (330–1452).