Definition & Etiology
Definition
- Acute kidney injury (AKI): rapid deterioration in kidney function over hours to days
- Failure to maintain fluid, electrolyte and acid-base balance
Prevalence
- 1 in 5 hospital/emergency department admissions
Etiology
Pre-renal (most common):
- Hypovolaemia: diarrhoea, vomiting, dehydration, burns, bleeding
- Decreased cardiac output: sepsis, heart failure, liver failure
- Medications: ACE inhibitors, ARBs, NSAIDs, loop diuretics, spironolactone
Intrarenal:
- Nephrotoxics: aminoglycosides, PPIs, allopurinol, iodine contrast, chemotherapy
- Vascular: vasculitis, thrombi, emboli
- Glomerular nephritis
- Tubular: myeloma, rhabdomyolysis, acute tubular necrosis
- Interstitial nephritis
Post-renal:
- Obstruction: stones, blood clots, blocked catheters
- Masses/tumours
- Hydronephrosis
- Enlarged prostate
- Neurogenic bladder