Which action would help prevent kidney trauma in a patient with kidney disease

Who has a higher chance of getting AKI?

People who are sick and in the hospital have a higher chance of AKI. People who are in the intensive care unit (ICU) are even more likely to have AKI. 

You have a higher chance of AKI if you:   

• Just had bypass (or other major) surgery
  

• Were in the hospital for COVID-19 (coronavirus)
• Are age 65 or older
• Have heart disease, congestive heart failure or COPD (chronic obstructive pulmonary disease)   
• Have a history of kidney disease
• Have severe, uncontrolled high blood pressure
• Take insulin for diabetes 
• Have peripheral artery disease (a condition that makes it hard for your blood to get to your arms and legs)
• Are severely dehydrated or unable to keep fluids in your body  

What are the symptoms of AKI?

In milder forms of AKI, there may not be any signs or symptoms and your doctor may find it when doing tests to look for other things.

In more severe forms of AKI, signs and symptoms may include:

• Urinating (peeing) less often
• Swelling in your legs, ankles or feet
• Feeling weak and tired
• Feeling like you cannot catch your breath
• Feeling confused
• Feeling sick to your stomach 
• Feeling pain or pressure in your chest
• Seizures or coma (in severe cases of AKI)

If you notice a combination of any of these symptoms, talk to your doctor.  

How long does AKI last?

In some cases, AKI may get better in a couple of days with observation, or medicine and fluids if needed. But sometimes the AKI is severe or affects other parts of the body, and recovery may take weeks or months.

What causes acute kidney injury?

AKI can have many different causes, but AKI usually happens when:      

There is not enough blood flow to your kidneys (prerenal)

Some conditions can restrict blood flow to your kidneys, including:

• Low blood pressure

• Severe bleeding

• Severe diarrhea

• Heart disease or heart attack

• Sepsis infection

• Liver failure

• Using more NSAIDS (nonsteroidal anti-inflammatory drugs), such as aspirin, ibuprofen or naproxen, than the label recommends 

• Severe burns

• Severe dehydration (not having enough water in your body)

• Severe allergic reaction

There is direct damage to your kidneys (intrarenal)

Some conditions can cause damage to your kidneys and lead to AKI, including:

• Blood clots in your kidneys

• Diseases that affect the kidneys, such as glomerulonephritis and lupus nephritis

• Infection

• Medicines, such as:

  • Some chemotherapy drugs

  • Some antibiotics 

  • Contrast dyes used in CT scans, MRIs and other imaging tests

• Alcohol or drug abuse

• Some blood or blood vessel disorders, such as vasculitis 

There is a blockage in your urinary tract (postrenal)

Some conditions can cause a blockage in your ureters (the tubes that take urine from your kidneys to your bladder), including:

• Some cancers

• Blood clots in or around the kidney vessels 

• Kidney stones

• Bladder problems

• Enlarged prostate

How do doctors treat AKI?

The treatment for AKI depends on the cause and severity. Some people need to be treated in a hospital and stay until their kidneys heal. Possible treatments include:

• Medicines to control your blood pressure and adjust the electrolytes in your blood
• Treatments to keep the right amount of fluid in your body (e.g. diuretics to make you pee out extra fluid) 
• If the AKI is severe and your kidneys completely stop working, going on dialysis for a short period of time. Dialysis is a treatment that uses a machine to clean your blood. Dialysis will do the work that your kidneys should be doing until they can recover.
• When you return home, following a kidney-friendly eating plan to help your kidneys heal. Your doctor may refer you to a registered dietitian.

You may have other treatments to optimize the healing of your kidneys.

How can I prevent AKI? 

It can be hard to predict or prevent AKI. But living healthy and taking good care of your kidneys can help. If you have any of these causes, talk to your doctor about how you can prevent AKI.

Related resources

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Glomerulonephritis (Glomerular Disease)

Learn about the causes, symptoms and treatment of glomerulonephritis, a type of kidney disease that can lead to serious kidney problems.

What protects the kidney from external trauma?

They are protected by the spine, lower rib cage, and strong muscles of the back. This location protects the kidneys from many outside forces. The kidneys are also surrounded by a layer of fat. The fat helps to cushion them.

What treatment is preferred for a kidney trauma patient with a Grade 5 injury?

Options for intervention in grade 5 isolated renal injury include angio-embolization and/or nephrectomy either immediately or as a delayed procedure. Angio-embolization has been shown to be effective in grade 5 renal injury with acceptable short and intermediate term outcomes.

How is kidney trauma treated?

Today, most kidney injuries are handled without surgery. Many serious injuries can be treated with minimally invasive techniques. One method is angiographic embolization. Using this method, surgeons can reach the arteries of the kidneys through large blood vessels in the groin to stop bleeding.

How does trauma affect the kidneys?

Renal trauma can result in injury to the parenchyma or the renal vasculature which can cause bleeding or injury to the collecting system with possible leakage of urine. Overall, genitourinary tract injuries are rare (10% of all traumas) with the most commonly affected organ being the kidney.