Acute kidney injury refers to the rapid decline of kidney function over hours or days. It reduces urine output and allows waste to build up in the blood. Causes include reduced blood flow to the kidneys (prerenal), kidney tissue damage (intrarenal), or urine blockage (postrenal). Treatment focuses on fluid balance, electrolytes, nutrition, and sometimes dialysis to restore function and remove waste if kidneys fail. The consequences are fluid and electrolyte imbalances and uremia if waste builds up in the blood.

1. Acute Kidney Injury
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2. Acute Kidney Injury
 Acute Kidney Injury: refers to the rapid decline of kidney
function over a period of hours or days;
 The loss of kidney function reduces urine output and allows
nitrogenous wastes to build up in the blood.
 The degree of renal dysfunction varies from mild to severe.
 With prompt treatment, acute kidney injury is often reversible,
although mortality rates are high, ranging from 60 to 70 percent
in severe cases.

3. Causes of Acute Kidney Injury
 Many disorders can lead to acute kidney injury, and it often
develops as a consequence of critical illness, or major surgery.
The causes of acute kidney injury are categorized into three
factors;
1. Prerenal; conditions that cause a severe reduction in blood
flow to the kidneys
2. Intrarenal; Factors that damage kidney tissue, such as
infections, toxicants, drugs, etc
3. Postrenal factors are those that prevent urine excretion due
to urinary tract obstructions.

4. Prerenal Factors
 Low blood volume or pressure: for example shock,
severe diarrhea, diuretics medications
 Renal artery disorders: example blood clots and
trauma
 Heart disorders: example heart failure

5. Intrarenal Factors
 Renal ischemia: which refers to the reduction of glomerular
filtration rate which may be caused by blood clotting
 Renal injury: as a result of drugs, infections, Escherichia coli
food poisoning, environmental contaminants
 Obstructions (within kidney): inflammation, tumors, scar tissue

6. Postrenal Factors
 Obstructions (ureter or bladder): strictures(restyriction), tumors,
stones, trauma (deeply depressing condition)
 Prostate disorders: cancer, enlarged prostate
 Renal vein thrombosis (when the vein which carries blood to the
hearted, located next to the ureter coagulates preventing urine
to go to the bladder for storage).
 Bladder disorders: neurological conditions, bladder rupture
 Pregnancy

7. Consequences of Acute Kidney
Injury
There are two major consequences of acute kidney injury and these
are;
 Fluid and Electrolyte Imbalances About one-half to two-thirds of
patients with acute kidney injury experience oliguria(condition
characterized by diminished urine quantity), producing less than
about 400 milliliters of urine per day (normal urine volume is about
1000 to 1500 milliliters daily).
 Uremia As a result of impaired kidney function, nitrogen-
containing compounds and various other waste products may
accumulate in the blood—a condition referred to as uremia.

8. Treatment of Acute Kidney Injury
Treatment of acute kidney injury involves a combination of drug therapies,
dialysis and nutrition therapy to restore fluid and electrolyte balances and
minimize blood concentrations of toxic waste products.
 Drug Treatment for Acute Kidney Injury: Because kidney function is required
for drug excretion, patients may need to use lower doses of their usual
medications to compensate for limited urine output.
 Energy and Protein Acute kidney injury is often associated with other critical
illnesses, so patients may be hypermetabolic, catabolic(breakdown of
complex molecules eg proteins and lipids, and at high risk of wasting.
Furthermore, patients with acute kidney injury frequently develop
hyperglycemia and hypertriglyceridemia because they are unable to
metabolize energy nutrients efficiently. For these reasons, patients must
ingest sufficient protein and energy to preserve muscle mass but should not
be overfed.

9.  Fluids: Fluid balance must be restored in patients who are either
overhydrated or dehydrated.
 Electrolytes Serum electrolyte levels are monitored closely to
determine appropriate electrolyte intakes. Depending on the
results of laboratory tests and the clinical assessment, restrictions
may be necessary for potassium, phosphorus, and sodium.
 Enteral and Parenteral Nutrition Many patients need nutrition
support to obtain adequate energy and nutrients. Enteral support
(tube feeding) is preferred over parenteral nutrition (delivered into
veins) because it is less likely to cause infection.