Acute kidney injury (AKI), also known as acute renal failure, can be caused by several factors that lead to a sudden reduction in kidney function. It is classified as pre-renal, intra-renal, or post-renal. Common causes include decreased blood flow to the kidneys, damage to the kidney tissues, or blockage of urine flow. AKI progresses through oliguric, diuretic, and recovery phases and is usually reversible with medical treatment. Patient care focuses on monitoring vital signs, fluid balance, nutrition, and treating any complications through supportive care or dialysis.

1. KALENGA PIWA

2.  It is the sudden interruption of renal function
resulting from obstruction, reduced
circulation, or renal parenchyma disease.
 The disease is classified as pre-renal, intra-
renal or post –renal and normally passes
through 3 distinct phases- oliguric, diuretic
and recovery.
 Usually reversible with medical treatment.

3.  Acute Renal Failure may be classified as
pre-renal, intra- renal and post –renal.
 Pre-renal causes.
 Hypovolemic shock.
 Burns.
 Sepsis.
 Dehydration.
 Trauma.
 Heart failure.

4.  Eclampsia
 Antihypertensive drugs.
 Hypertension.
 All conditions that lead to pre-renal failure
impair renal perfusion, resulting in decreased
glomerular filtration and increased proximal
tubular reabsorption of sodium and water.

5.  Results from damage to the kidneys
themselves.
 Acute glomerulonephritis.
 Acute pyelonephritis.
 Sickle cell.
 Eclampsia.
 Septic abortion.
 Crush injury releases myoglobin which
damages the kidney.
 Uterine haemorrhage.

6.  Nephrotoxins such as phenacetin,
methoxyflurane, Gentamicin, lead.
 Sepsis.
 Transfusion reaction.

7.  Results from obstruction of urine flow.
 Calculi.
 Tumour.
 Stricture.
 Blood clots.
 Anticholinergic drugs.
 Prostatic hypertrophy.
 Oedema or inflammation.

8.  Infection.
 Surgery ( accidental ligation).
 uric acid crystals.

9.  Usually history of renal disorder, fever, chills.
 Anorexia.
 Nausea.
 Vomiting.
 Diarrhoea.
 Constipation.
 Headache.

10.  Irritability.
 Drowsiness.
 Confusion.
 Alterations in level of consciousness.
 Seizures.
 Oliguria (less than 400ml/24 hours)
 Anuria (less than 100ml/24 hours)

11.  Bleeding tendencies.
 Haematemesis.
 Skin may be dry and pruritic.
 Mucous membranes may be dry.
 If there is hyperkalaemia, there may be
muscle weakness.

12.  Blood – Urea, nitrogen, serum creatinine and
potassium level and low blood PH
bicarbonate haematocrit and HB levels.
 Urine specimen shows casts, cellular debris.
 Kidney ultrasonography.
 KUB radiography.
 Renal scan.
 Retrograde pyelography.

13.  CT Scan.
 ECG will reveal tall T waves, widening QRS
Complex, and disappearing P waves if
hyperkalaemia is present.

14.  Supportive – high calorie diet, and low
protein, sodium and potassium.
 Electrolyte monitoring.
 If hyperkalaemia is present, give glucose and
insulin and bicarbonate IV.
 If this fails consider haemodialysis.

15.  Electrolyte imbalance.
 Metabolic acidosis.
 Circulatory overload.
 Pulmonary oedema.
 Hyperkalaemia.
 Infection.

16.  The patient is nursed in a quiet room, clean,
warm, well ventilated.
 Explain the condition to the patient and
family in simple terms.
 Measures should be carried out to prevent
infection because the patient is highly
susceptible to infection.
 Visitors should be restricted.

17.  Measure and record intake and output of all
fluids.
 Universal precautions should be used when
handling blood and body fluids.
 Weigh patient daily as well as abdominal
girth.
 Monitor vital signs.
 Maintain proper electrolyte imbalance.

18.  Watch for signs of hyperkalaemia such as
malaise, anorexia, paresthesia, muscle
weakness and ECG changes.
 Maintain nutritional status.
 Provide high calories, and low proteins,
sodium, and potassium, with vitamin
supplements.
 Assist patient in exercising.

19.  Add lubricating lotion to combat skin
dryness.
 Mouth care should be carried out.
 Use bed with rails in case of patient who is
restless or dizzy who may fall off the bed.
 If patient is on dialysis, monitor vital signs,
blood flow, arterial and venous pressure.
 Also position patient carefully, elevating his
head to reduce pressure on the diaphragm.

20.  Provide emotional support to patient and
family.
 Assess patients ability to resume normal
activities.
 IEC
 Reassure patient and family by clearly
explaining procedures, investigations and
treatment.

21.  Importance of taking medication as
prescribed by the physician.
 State the importance of following the
prescribed diet and fluid intake.
 Instruct patient to daily weigh themselves.
 Advise patient against exertion.
 If dyspnoeic should report to the Doctor.

22.  This is the progressive loss of renal function.
 CAUSES.
 Chronic glomerular disease such as
glomerular disease.
 Chronic infections such as pyelonephritis or
tuberculosis.
 Congenital anomalies.

23.  Obstructive processes such as calculi.
 Nephrotoxic agents.
 Endocrine diseases such as diabetic
neuropathy.
 Clinically almost all the systems of the body
are affected.
 Treatment is more or less as Acute Renal
failure.

24.  END OF SHOW
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