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ACUTE KIDNEY INJURY

Kidney is one part of the urinary system (urology) which is shaped like a bean on each side
of the body. Despite their small size, the kidneys have an important role in regulating the
volume and composition of fluids in the body, as well as removing metabolic waste and
toxins from the body in the form of urine. When kidney function is disturbed, the body's
waste and fluid will accumulate in the body and will cause various problems with the body's
excretory system.

Acute Kidney Injury (AKI) also known as Acute Renal Failure (ARF) is one of the various
problems in the urinary system (urology). Acute Kidney Injury (AKI) occurs when your
kidneys suddenly become unable to filter waste products from our blood. It is characterized
by increased levels of creatinine and urea in the blood, as well as a decrease in the
glomerular filtration rate followed by kidney failure to secrete metabolic wastes. So, It can
be seen that when our kidneys lose their filtering ability, dangerous levels of waste may
accumulate, and and our blood’s chemical may get out of balance. And after that our
kidneys will suddenly stop working. Acute Kidney Injury (AKI) can also affect other organs
such as the brain, heart, and lungs. If AKI not treated quickly, it can lead to permanent
failure that can be life threatening. However, AKI may be reversible, you may recover
normal or nearly normal if you’re in good health.

Acute Kidney Injury (AKI) dapat disebabkan oleh berbagai macam factor, but most cases of
AKI are caused by reducted blood flow to the kidneys, usually in someone who’s already
unwell with another health condition. AKI can be classified into 3 types, includes pre-renal
AKI, acute post-renal obstructive nephropathy and intrinsic acute kidney diseases. Of these,
only “intrinsic” AKI represents true kidney disease, while pre-renal and post-renal AKI are
the consequence of extra-renal diseases leading to the decreased glomerular filtration rate
(GFR). If these pre or post renal conditions persist, they will eventually evolve to renal
cellular damage and hence intrinsic renal disease.

Pre-renal type is an adaptive response of the kidneys to volume depletion and hypotension.
Usually it can be related to the structure of the nephrons of the kidney. This type is the most
common type of AKI that can be transform into “intrinsic” AKI. After that, there is “intrinsic”
type. “Intrinsic” type occurs when kidney function is impaired due to cytotoxic, ischemic, or
inflammatory. “Intrinsic” AKI is the most progressive AKI than other types of Acute Kidney
Injury. The last type, there is post-renal that caused by a blockage in the flow of urine.

To diagnose AKI, we need to know how our kidneys function which can be shown by
supporting kidney tests, such as blood test, urine test, USG, CT scans, or MRI and also
kidney biopsy. In examining kidney function using the blood test method in patients with
ARF, we can find an increase in creatinine and urea levels, and measure the glomerular
filtration rate to see the severity of acute kidney failure. Apart from kidney function tests, we
can also diagnose ARF through serological tests that can identify hemolytic-uremic syndrome
and thrombotic thrombocytopenic purpura which are the causes of ARF. If you have
confirmed the diagnosis of ARF, we can also perform examinations that can determine the
etiology of ARF such as abdominal ultrasound to see the condition of the kidneys, aortorenal
angiography examination can also see the condition of the kidney blood vessels, and kidney
biopsy. However, Acute Kidney Injury (AKI) can also be diagnosed by various forms of
symptoms, such as reduced amount of urine and frequency or urination, swelling in the legs
due to fluid buildup, heart rhythm disturbances, and pain or a feeling of pressure in the chest.

There are many kind of efforts that can be made to restore kidney function in patients with
Acute Kidney Injury (AKI). But, this effort also depends on what's causing your illness and
how severe it is. some patients usually need to stay in the hospital for a few days or weeks,
depending on the severity of the condition and how quickly the kidneys recover. You may
need regulating diet by limiting the consumption of foods high in salt also potassium during
the kidney healing process, administering drugs that can balance electrolyte levels in the
blood and diuretic drugs to remove excess fluid, injectable antibiotics to treat kidney failure
caused by bacterial infection.

Most people with AKI make a full recovery, but some people go on to develop chronic
kidney disease or long-term kidney failure as a result. In severe cases, dialysis, where a
machine filters the blood to rid the body of harmful waste, extra salt and water, may be
needed.

Acute Kidney Injury (AKI) is often difficult to predict or prevent. But you may reduce your
risk by taking care of your kidneys. Try to make a healthy lifestyle and also not holding back
urination to prevent recurrent urinary tract infections.