​Acute Kidney Injury

Acute kidney injury (AKI), previously known as “Acute Renal Failure” is a rapid (days to weeks) decline in the kidneys’ ability to filter wastes from food and excess water. While potentially reversible, AKI requires early diagnosis and intensive treatment. 

About 15% of patients entering hospital with an acute illness will have some reduction in kidney function, but AKI that is severe enough to require dialysis is quite rare. In more than 90% of cases, the kidneys usually recover to their original level of function, if the patient survives.

There are many causes of AKI. The most common are dehydration (due to vomiting and diarrhea), infections, drugs (for example certain antibiotics, pain killers) and blockage of one or both of the tubes leading from the kidneys to the bladder. Some people are more at risk of developing AKI than others, especially if they are older and have other medical conditions; for example underlying kidney disease, heart failure or diabetes. Sometimes drugs that are being taken for other reasons can affect the kidneys, leading to AKI.

The most common symptoms are:

  • passing less urine than usual

  • unexplained loss of appetite

  • feeling sick or vomiting

  • feeling short of breath

  • swelling of the legs or other body parts

Sometimes AKI can occur without any symptoms and can only be picked up by a blood test.​

The symptoms for acute renal failure might resemble those from other diseases. To confirm its presence, you should consult your doctor or the internationally recognized panel of nephrologists from the Kidney and Bladder Service Line​ at the Aga Khan University Hospital. Due to the intensive nature of the treatment, it is important to get the proper diagnosis early on in the treatment. ​​
Your time with your doctor maybe limited, so make sure to prepare for your visit beforehand. Here are some tips to help get you started.​

The testing phase might begin with the standard procedure of conducting a physical examination followed by a compilation of your medical history. If your symptoms suggest AKI, your doctor may suggest a Urine test for revealing any abnormalities hinting at kidney failure. This might be followed by a Blood test aimed at determining blood cell count along with creatinine and urea levels. This information helps in measuring the kidney function.

Imaging tests might also be conducted to visually determine abnormalities in the shape, size, form and mass of your kidney along with the possible presence of cysts. These tests might include renal ultrasound, computerized tomography (CT) scan and general X-rays.

To determine possible causes of kidney failure, a urine test might be performed to measure the daily amount of urine excretion. 

Very occasionally a kidney biopsy may be needed to workout what is causing AKI. This involves taking a very small sample of tissue from one kidney using a fine needle .

Complete blood count (CBC): One or more parameters related to red blood cells, white blood cells and platelets might be affected in this condition, giving a clue towards etiology and further diagnostic approach. Therefore, it is an ancillary test in the diagnostic workup of this disease.

Disclaimer: Kindly consult your physician before getting the above-mentioned tests.

Treatment for AKI will depend on the underlying cause. Some patients may need fluids via a drip if they are dehydrated. If there is an infection then antibiotics may be used. If there is a blockage of the bladder, then a catheter may be needed (this involves a thin, flexible tube being inserted into the bladder to drain it). Rarely, drugs such as steroids may be needed to help prevent further damage to the kidneys.

In certain cases, AKI can get worse despite the above mentioned measures. When this occurs, dialysis is sometimes needed. Dialysis is a treatment that involves being connected to a special machine that cleans the blood. This is usually a temporary treatment while the kidneys recover. Very rarely (in about 3 in 100 patients), the kidneys fail to recover meaning that treatment with dialysis will need to continue permanently.​​

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

​The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the 'Important Numbers' section on the website homepage.

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments' costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the 'Important Numbers' section on the website homepage. ​

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the 'Important Numbers' section on the website homepage.

​​The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.