Thursday, 14th March, 2019
This year, World Kidney Day aims to raise awareness of the significance of kidney diseases, and the importance of promoting kidney disease prevention and management. In this piece, we’ll look at Acute Kidney Injury (AKI) in particular, which is caused by various factors and may lead to the development of chronic kidney disease.
What do kidneys do?
Your kidneys are essential organs in your body that play an important role in keeping you healthy. Here’s why:
- They filter your blood up to 30 times a day; only retaining what is needed and expelling the rest (waste) through the production of urine. This process helps to balance the amount of fluid in your body and regulate blood pressure.
- They play a role in turning Vitamin D into a form that is useful for the body; a vitamin that helps to keep your bones healthy.
- They produce a hormone (Erythropoietin) which tells your body to make red blood cells, which are needed to carry oxygen around your body.
- They work 24/7, require 25% of your body’s total energy to function, and will continue to work until they can absolutely no longer do so (when up to around 90% of your kidney function is gone).
What is Acute kidney injury (AKI)?
Acute Kidney Injury (AKI) happens when there is sudden damage to the kidneys so they are no longer able to work properly. Despite its name, it isn’t caused by a physical injury to the kidneys but instead as a result of other complications in the body. The elderly tend to be more at risk of AKI due to being unwell with other illnesses where the kidneys are also affected.
It is estimated that one in five emergency hospital admissions will have or develop AKI, and that around 20% of these cases are preventable. If AKI is not spotted and treated early enough, kidney function may deteriorate further very rapidly or even shut down completely, and other organs or existing illnesses in the body may be affected as a result. It may also change how some medications are handled by the body. While it may lead to chronic kidney disease (CKD), it should not be mistaken for CKD as this is a condition where the kidney function reduces gradually over a longer period of time.
How will I know if I have AKI?
Signs or symptoms of AKI may not always be present or apparent, particularly in the early stages. Somebody with AKI may start to feel unwell very quickly with the sudden onset of symptoms such as:
- Significant reduction in the amount of urine they pass
- Stomach ache, nausea and vomiting
- Dehydration/feeling thirsty
- Feeling confused, tired and generally unwell
- Fluid build-up in the body
If you spot any warning signs or symptoms or are concerned about your kidney function, follow up with your GP.
What causes AKI?
Acute kidney injury may be caused by one or a combination of various factors. These can include other illnesses or infection causing stress to the kidneys, severe dehydration or adverse effects of some medications.
In general, AKI will be precipitated by a reduction in blood flow to the kidneys, particularly if someone is already unwell with another condition. Severe vomiting, diarrhoea or dehydration can lower blood volume. Heart & liver failure or sepsis may reduce the amount of blood the heart pumps out. Complications with blood vessels in the kidneys and medicines that affect the blood supply to or other functions of the kidney can also lead to reduced blood flow.
AKI can also be caused by damage to the part of the kidneys that filter the blood, or by a blockage that prevents drainage in the kidneys.
You may be more prone to developing AKI if:
- you are over the age of 65
- you have an existing kidney problem or other health condition
- you are dehydrated
- you have or are at risk of a urinary tract blockage
- you have a serious infection or sepsis
- you take certain medicines that affect how the kidneys work
If you have one or more of these high-risk factors, it’s a good idea to speak to your GP about checking up on your kidney function.
How can medication I take affect my kidneys?
Some medicines can make the kidney less efficient at its normal role. These may include non-steroidal anti-inflammatory inhibitors (NSAIDs), blood pressure medicines, diuretics and some antibiotics & antivirals medicines.
With blood pressure medicines, however, any risk from the medication needs to be offset against the benefits of controlling blood pressure. Uncontrolled high blood pressure is a leading cause of kidney damage.
Each drug affects different parts of the kidney in different ways, so there is a diverse range of actions behind any resulting in kidney damage.
It's always best to speak with your GP about the benefits and potential risks of your medication, and whether you may need to see them for regular monitoring whilst you are taking the medication. I
If you have trouble keeping track of when to take your medication, Echo sends you daily reminders of when to take your medication and when you're about to run out, making it one less thing for you to worry about!
What can I do to help protect my kidneys?
As your kidneys have a significant role in your overall health, it’s important to do what you can to keep them healthy.
Drinking plenty of water helps your kidneys do their job. It helps them to clear waste and toxins from your body, which would otherwise build up and cause damage to your kidneys. If you feel thirsty, it’s your body’s way of telling you that you’re dehydrated. The general recommendation is to drink 2 litres of water per day, although this may vary depending on your overall health and lifestyle. You’ll usually need to drink more water in hot weather or when you exercise, to replace the fluid lost through sweating. If you don’t like the taste of plain water, you can add fruit or herbs to freshen the taste.
Eat healthily and watch your weight
Maintaining a healthy balanced diet will help to provide your body with enough vitamins and minerals. Try not to have too much salt, sugar or fatty foods. Being overweight can also be harmful to your kidneys. It’s good to keep an eye on your BMI to maintain a healthy weight.
Quit smoking and cut down on alcohol
Both smoking and alcohol can cause an increase in blood pressure and reduce blood flow to your kidneys, which in turn can lead to kidney problems. One of the best things you can do not just for your kidneys but for your overall health is to quit smoking. Limiting alcohol intake will also help to reduce the risk of kidney damage.
Be fit and active
Exercise or physical activity helps to reduce your blood pressure, reducing your risk of developing kidney disease. As well as protecting the kidneys, exercise has many other health benefits. It’s good to keep a check on your blood pressure in general and to know what the ideal level should be.
If you have one or more risk factors for AKI and you become unwell suddenly or start any new medications, it’s a good idea to have regular check-ups with your GP. It’s also worth keeping an eye on how much urine you are passing and looking out for warning signs and symptoms associated with AKI.
Want to learn more about how to keep your kidneys healthy? Check out the NHS website for more information.
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