Understanding Acute Kidney Injury and the Need of Acute Dialysis

Understanding Acute Kidney Injury and the Need of Acute Dialysis

What is AKI?

Acute Kidney Injury (AKI) is a sudden decrease in kidney funcon over hours to days. The kidneys may stop filtering waste and balancing fluids, salts, and electrolytes in your body properly.

Causes of AKI

· Low blood flow to kidneys (e.g., from dehydraon, heart failure)

· Direct damage to the kidneys (e.g., from toxins, medicaons)

· Blocked urine flow (e.g., from enlarged prostate or kidney stones)

Symptoms of AKI

· Decreased urine output

· Swelling in legs, ankles, or around eyes

· Fague or confusion

· Nausea or voming

· Shortness of breath

Diagnosing AKI

· Blood tests: Blood urea nitrogen (BUN) and creanine levels help inform doctors about toxic levels in the blood.

· Urine tests: Detect protein or abnormalies

· Imaging: Ultrasound or CT scan to view kidneys

Treatment for AKI

· Treat the cause: Rehydrate, stop harmful medicaons, treat infecon

· Manage symptoms: Control fluid, electrolytes, and blood pressure

· Temporary dialysis may be needed if the kidneys are severely impaired

Types of Acute Dialysis

Hemodialysis (HD): Blood is cleaned using a machine (frequency of dialysis will be decided by your Nephrologist)

Connuous Renal Replacement Therapy (CRRT): Slower, connuous dialysis, usually in ICU sengs

Peritoneal Dialysis (less common in AKI): Uses the lining of your abdomen to filter blood

When is Dialysis Needed in AKI?

Ø Very high potassium (a dangerous electrolyte)

Ø Severe fluid overload (especially causing breathing trouble)

Ø Acid buildup in the blood (acidosis)

Ø Confusion or coma due to waste buildup

Ø No improvement with other treatments

What to Expect with Acute Dialysis?

ü A temporary catheter is placed in a large vein (neck or groin)

ü Each session may last 3–4 hours (for hemodialysis)

ü Your healthcare team will monitor your blood pressure, weight, and blood tests closely

Will My Kidneys Recover?

ü Many paents with AKI recover kidney funcon, especially if the cause is found and treated early.

ü Some may need longer-term dialysis or develop chronic kidney disease (CKD)

How Can I Help My Kidneys Heal?

ü Follow fluid and diet instrucons

ü Take medicaons as prescribed

ü Avoid NSAIDs (like ibuprofen, Diclofenac, Naproxen, Piroxicam, Ketorolac and Mefenamic acid) unless approved

ü Hypotension (Low Blood Pressure):

o Low blood pressure during or aer dialysis can cause weakness, dizziness, and headache, potenally accompanied by cramps.

ü Musculoskeletal Pain:

o Kidney disease and dialysis can contribute to pain in joints, back, and other muscles, potenally due to underlying condions or the effects of dialysis itself.

ü Nerve Damage (Neuropathy):

o Kidney disease can damage nerves, leading to numbness, ngling, and pain, oen in the extremies.

ü Infecons:

o Dialysis-related infecons, such as those at the access site or within the peritoneum, can cause pain.

ü Abdominal Pain:

o While less common, nonocclusive mesenteric ischemia (NOMI) can cause abdominal pain aer dialysis, requiring prompt diagnosis and treatment.

Maintaining Dialysis catheter:

ü Keep the catheter dressing clean and dry at all mes.

ü Change the dressing at least every 7 days or when it appears loose or dirty.

ü Use a clear, waterproof dressing to allow for easy inspecon and to protect the site from moisture.

ü If the dressing becomes wet, change it as soon as possible.

ü Hand Hygiene: clean your hands before and aer touching the catheter to avoid infecon risk

Infecon Monitoring:

o Look for signs of infecon, such as redness, swelling, pain, or discharge.

o Report any signs of infecon to your healthcare team immediately.

Important Consideraons:

o Diet and Fluid Intake: Follow a diet plan and fluid restricons as recommended by your healthcare team.

Changes in diet will be required and these instrucons will be provided to you by your care team (Nephrologist, Nutrionist, Medical specialist).

What is Acute Dialysis?

When your kidneys can't clean your blood well enough, dialysis may be used to remove waste, excess fluid, and balance chemicals.

ü Keep follow-up appointments and blood tests

Post-dialysis pain

ü Muscle Cramps:

o Rapid fluid removal during dialysis can disrupt electrolyte balance, leading to muscle cramps.

Emergency Situaons:

· If the catheter dislodges but doesn't fall out, do not try to push it back in.

· Contact your dialysis unit immediately.

· If the catheter falls out, apply pressure to the site with a clean cloth and contact your dialysis unit.