Acute Kidney Injury
Acute kidney injury is a rapid decline in renal function occurring over hours to days, marked by rising serum creatinine and/or decreased urine output, leading to impaired waste excretion and fluid-electrolyte imbalance.
Acute Kidney Injury (AKI)
1. Definition
Acute Kidney Injury (AKI) — let's break the name down first:
- "Acute" = sudden onset (hours to days, not months)
- "Kidney" = the organ affected
- "Injury" = damage — importantly, not "failure." The terminology deliberately shifted from "acute renal failure" (ARF) to AKI to capture the spectrum from mild injury to complete organ failure, because even mild injury matters [1][2].
AKI is an abrupt decrease in kidney function, resulting in the retention of urea and other nitrogenous waste products and in the dysregulation of extracellular volume and electrolytes [1][3].
The key conceptual point: AKI is not a single disease. It is a clinical syndrome — a common final pathway of many different insults to the kidney. Think of it like "heart failure" — it's a syndrome, not a diagnosis. Your job is to find the cause.
AKI is defined as at least ONE of the following (KDIGO 2012) [1][3][4]:
- ↑ serum creatinine (sCr) by ≥ 26.5 μmol/L (0.3 mg/dL) within 48 hours
- ↑ serum creatinine to ≥ 1.5× baseline, known or presumed to have occurred within 7 days
- Urine output < 0.5 mL/kg/h for 6 hours
Why these specific numbers?
- The 26.5 μmol/L absolute rise catches early, small increments even in patients with low baseline creatinine (e.g., a frail elderly woman with baseline Cr 50 → 77 is already AKI Stage 1).
- The 1.5× baseline catches relative changes in patients with higher baselines.
- Urine output is included because it can detect AKI before creatinine rises (creatinine is a lagging indicator — by the time it rises, GFR has already dropped ~50%) [4][5].
High Yield – Exam Point
Serum creatinine is NOT a good marker for early renal impairment — GFR has already dropped by approximately 50% by the time creatinine starts to rise. This is because creatinine generation is roughly constant, and the relationship between GFR and sCr is hyperbolic (not linear). Novel biomarkers like NGAL (neutrophil gelatinase-associated lipocalin) and cystatin C are under investigation to characterize renal damage earlier — analogous to cardiac enzymes (troponin) for MI [4][5].
Staging allows grading of severity and guides clinical decisions [1][3][4]:
| Stage | Serum Creatinine Criteria | Urine Output Criteria |
|---|---|---|
| Stage 1 | ↑ sCr 1.5–1.9× baseline OR ≥ 26.5 μmol/L increase | < 0.5 mL/kg/h for 6–12 hours |
| Stage 2 | ↑ sCr 2.0–2.9× baseline | < 0.5 mL/kg/h for ≥ 12 hours |
| Stage 3 | ↑ sCr ≥ 3.0× baseline OR ↑ to ≥ 353.6 μmol/L OR initiation of RRT OR eGFR < 35 in patients < 18 years | < 0.3 mL/kg/h for ≥ 24 hours OR anuria for ≥ 12 hours |
The objectives of AKI definition and classification are: (1) consistent meaning, (2) early identification, (3) grading according to severity, (4) expediting management and guiding clinical decisions, and (5) prognosis [1].
- RIFLE (Risk, Injury, Failure, Loss, ESKD) — originally developed for ICU patients; uses GFR decline and urine output [4][5]
- AKIN (Acute Kidney Injury Network) — refined RIFLE; essentially absorbed into KDIGO
- pRIFLE — paediatric version using estimated creatinine clearance (eCCl) [4]:
- Risk: ↓eCCl by 25%
- Injury: ↓eCCl by 50%
- Failure: ↓eCCl by 75% or oliguria < 0.3 mL/kg/h for 24h or anuria for 12h
- Loss: persistent failure > 4 weeks
- End-stage: persistent failure > 3 months
Which Staging System to Use?
In Hong Kong, the KDIGO staging system is the most commonly used [5]. RIFLE is still referenced, especially in ICU settings. For exams, know KDIGO cold.
2. Epidemiology
- AKI is extremely common in hospitalized patients:
- Affects approximately 10–15% of all hospital admissions
- Up to 50–60% of ICU patients develop some degree of AKI
- Community-acquired AKI is less common but increasingly recognized (especially in elderly patients on nephrotoxic drugs)
- In Hong Kong, pre-renal causes (especially dehydration and sepsis) remain the most common cause of AKI [3]
- Drug-related AKI is very important locally:
- NSAIDs — widely available over-the-counter
- Chinese herbal medicines — aristolochic acid nephropathy (unique to the region); causes acute-on-chronic tubulointerstitial nephritis
- Contrast nephropathy — significant given the volume of CT scans and percutaneous coronary interventions performed
- Aminoglycosides — still used for serious infections (e.g., gentamicin)
- The ageing population in Hong Kong means more patients have pre-existing CKD, diabetes, and heart failure — all major risk factors for AKI [3]
- AKI is a poor prognostic marker — even mild AKI (Stage 1) is independently associated with increased mortality
- ICU patients with AKI requiring dialysis: mortality 40–60%
- Even mild, reversible AKI can have important long-term consequences such as transition to CKD [3]
| Category | Risk Factors |
|---|---|
| Age | > 50 years (reduced renal reserve, declining GFR) |
| Pre-existing kidney disease | CKD (most important risk factor), diabetic kidney disease |
| Cardiovascular | Heart failure (reduced renal perfusion) |
| Hepatic | Liver disease / cirrhosis (hepatorenal syndrome risk) |
| Volume status | Hypovolaemia (dehydration, haemorrhage, burns, third-space losses) |
| Infection | Sepsis (vasodilatory shock → renal hypoperfusion + direct tubular injury) |
| Surgical/Trauma | Post-operative (especially post-CABG), major trauma |
| Malignancy | Cancer (tumour lysis syndrome, obstruction, nephrotoxic chemotherapy) |
| Drugs | NSAIDs, ACEI/ARB, aminoglycosides, contrast agents, cisplatin, calcineurin inhibitors |
Why are these risk factors?
- Pre-existing CKD → reduced nephron mass means less functional reserve; a small insult causes proportionally greater damage
- Heart failure → chronic renal hypoperfusion via reduced cardiac output
- Liver disease → splanchnic vasodilation reduces effective circulating volume; may progress to hepatorenal syndrome
- Age > 50 → physiological decline in GFR (~1 mL/min/year after age 40), arteriosclerosis of renal vessels, and increased comorbidities
- Sepsis → the combination of systemic vasodilation, microvascular dysfunction, and direct inflammatory tubular injury makes it the leading cause of AKI in ICU
Young patients and AKI
Young subjects are NOT expected to have AKI — if a young person develops AKI, think hard about the cause: glomerulonephritis (e.g., IgA nephropathy, lupus nephritis), drug/toxin exposure, rhabdomyolysis, or obstructive uropathy [3].
4. Relevant Anatomy and Physiology
Understanding AKI requires understanding what the kidney does and where things go wrong.
The nephron is the functional unit of the kidney. Each kidney contains approximately 1 million nephrons [7]. Each nephron consists of:
-
Glomerulus — the filtration unit
- Receives blood from the afferent arteriole
- Filters plasma across the glomerular basement membrane (GBM) to produce an ultrafiltrate (~180 L/day)
- Filtrate exits via the efferent arteriole
- Normal GBM excludes cells and large proteins (> ~70 kDa) → normally no RBCs or significant protein in urine
-
Proximal Convoluted Tubule (PCT) — the workhorse
- Reabsorbs ~65–70% of filtered Na⁺, water, glucose, amino acids, bicarbonate, phosphate
- Highly metabolically active → most vulnerable to ischaemic and toxic injury (this is why ATN preferentially affects the PCT and thick ascending limb)
-
Loop of Henle — concentrating mechanism
- Descending limb: permeable to water
- Thick ascending limb (TAL): impermeable to water, actively pumps NaCl → creates the medullary concentration gradient
- TAL is also metabolically demanding → susceptible to ischaemic ATN
-
Distal Convoluted Tubule (DCT) and Collecting Duct
- Fine-tuning of Na⁺, K⁺, H⁺, water reabsorption
- Aldosterone acts here (Na⁺ reabsorption, K⁺ secretion)
- ADH acts on collecting duct (aquaporin-2 insertion → water reabsorption)
-
Renal interstitium — the scaffolding between tubules
- Participates in fluid/electrolyte exchange and endocrine functions (e.g., erythropoietin production by peritubular interstitial fibroblasts) [7]
Renal blood flow autoregulation:
- The kidney autoregulates blood flow across a MAP range of ~80–180 mmHg
- Below this range → GFR drops → AKI
- ACEI/ARBs dilate the efferent arteriole → reduce intraglomerular pressure → this is normally nephroprotective in CKD, but in acute hypovolaemia it can precipitate AKI (removes the kidney's compensatory mechanism to maintain GFR)
- NSAIDs inhibit prostaglandin synthesis → constrict the afferent arteriole → reduce renal blood flow → AKI. The "triple whammy" (ACEI/ARB + diuretic + NSAID) is a classic precipitant.
Tubuloglomerular feedback (TGF):
- The macula densa in the DCT senses NaCl delivery
- Low NaCl delivery → signals afferent arteriole dilation and renin release → maintains GFR
- This mechanism is disrupted by drugs and ischaemia
5. Aetiology and Pathophysiology
The classic framework divides AKI into pre-renal, renal (intrinsic), and post-renal causes. This is not just academic — it directly determines your management [3][6][8]:
Every possible cause of AKI can occur in any patient — the clinical classification into pre-renal, intrinsic renal, and post-renal guides your workup and management [8].
Definition: Reduced renal perfusion without structural kidney damage. The kidney itself is healthy but underperfused.
Pathophysiology: Reduced renal blood flow → reduced hydrostatic pressure in the glomerulus → reduced GFR → reduced urine output → retention of creatinine and urea. The tubules are intact and avidly reabsorb sodium and water (a normal physiological response to perceived hypovolaemia).
Key feature: Rapidly reversible if perfusion is restored. If hypoperfusion persists, it progresses to ischaemic acute tubular necrosis (ATN) — an intrinsic renal cause [6].
| Mechanism | Examples |
|---|---|
| Hypovolaemia (true volume depletion) | Dehydration (vomiting, diarrhoea), haemorrhage, burns, third-space losses (bowel obstruction, pancreatitis), trauma/major surgery [6] |
| Reduced cardiac output | Cardiogenic shock, heart failure, massive PE, cardiac tamponade |
| Systemic vasodilation | Sepsis, anaphylaxis, liver failure (hepatorenal syndrome) |
| Renal vasoconstriction | NSAIDs (afferent arteriole constriction), calcineurin inhibitors (cyclosporine, tacrolimus), hepatorenal syndrome |
| Efferent arteriole dilation | ACEI/ARBs (reduce intraglomerular pressure) |
Why does pre-renal AKI have a low fractional excretion of sodium (FENa)?
- The tubules are intact and functioning normally
- In response to perceived hypovolaemia, the RAAS is activated:
- Angiotensin II → proximal tubule Na⁺ reabsorption
- Aldosterone → distal tubule Na⁺ reabsorption
- Therefore, the kidney holds onto sodium avidly → FENa < 1%, urine Na < 20 mmol/L
- Urine osmolality is high (> 500 mOsm/kg) because ADH is maximally active → concentrated urine
5.2 Intrinsic Renal AKI (< 50% of cases)
Definition: Structural damage to the kidney parenchyma — glomeruli, tubules, interstitium, or vasculature.
This is further subdivided by the anatomical compartment affected:
"Necrosis" = "nekrosis" (Greek) = death. ATN = death of the tubular epithelial cells [7].
ATN is a medical condition involving the death of tubular epithelial cells that form the renal tubules of the kidneys. Common causes include low blood pressure and use of nephrotoxic drugs [7].
Two major subtypes:
| Type | Mechanism | Examples |
|---|---|---|
| Ischaemic ATN | Prolonged pre-renal hypoperfusion → tubular cell death | Shock (any cause), thrombosis (TTP, HUS, DIC), vasculitis, hepatorenal syndrome, renal artery stenosis [7] |
| Nephrotoxic ATN | Direct toxic injury to tubular cells | Exogenous toxins: aminoglycosides, cisplatin, contrast agents, heavy metals [7] |
| Endogenous toxins: myoglobin (rhabdomyolysis), haemoglobin (haemolysis), monoclonal light chains (myeloma) [7] |
Pathophysiology of ATN in detail:
- Initiation phase — ischaemic or toxic insult damages tubular cells, particularly in the S3 segment of the PCT and the medullary thick ascending limb (mTAL). These segments are the most metabolically active and exist in a relatively hypoxic environment (the outer medulla operates at PO₂ ~10–20 mmHg even normally).
- Extension phase — ongoing hypoxia, inflammation, and endothelial injury in the outer medulla. Detached tubular cells and cellular debris obstruct the tubular lumen → backleak of filtrate into the interstitium → further reduces effective GFR.
- Maintenance phase — GFR remains low despite restoration of renal blood flow. Cell repair and regeneration begin.
- Recovery phase — tubular cells regenerate, re-establish polarity and function. GFR gradually improves.
Clinical course of ATN [7]:
- Oliguric phase: oliguria < 500 mL/day, ↓ GFR, ↑ plasma urea, metabolic acidosis, hyperkalaemia
- Diuretic phase: gradual normalization of GFR, markedly ↑ urine output (up to 3 L/day), then urine output gradually returns to normal
Pathognomonic Finding
The presence of "muddy brown casts" of epithelial cells found in the urine during urinalysis is pathognomonic for ATN [7]. These are casts formed from necrotic tubular cells trapped in Tamm-Horsfall protein.
Why is ATN different from pre-renal AKI on urine tests?
- The tubules are damaged → they cannot reabsorb sodium properly
- FENa > 2% (sodium is being wasted)
- Urine osmolality is low (~300–350 mOsm/kg) — the kidney cannot concentrate urine
- Urine Na > 40 mmol/L
Interstitial nephritis is inflammation of the renal interstitium — the area surrounding the renal tubules. In addition to scaffolding support, the interstitium participates in fluid/electrolyte exchange and endocrine functions [7].
Causes:
- Drug-induced (most common cause — ~70%):
- Infection-related: pyelonephritis, leptospirosis
- Autoimmune: SLE, sarcoidosis, IgG4-related disease
- Idiopathic
Pathophysiology: Type IV hypersensitivity reaction (delayed-type) → T-cell mediated inflammation in the interstitium → oedema and inflammatory infiltrate compress tubules → reduced tubular function and GFR.
Clinical presentations of drug-induced AIN typically include renal impairment, and some patients show signs of a generalized drug hypersensitivity reaction: (1) fever, (2) rash, and (3) eosinophilia [7].
However, this classic triad is present in < 30% of cases. More often, it presents as unexplained AKI in a patient recently started on a new medication.
Urine findings: White cell casts, eosinophiluria (Hansel stain — sensitivity ~67%), sterile pyuria.
- Rapidly progressive glomerulonephritis (RPGN) — a nephrological emergency
- Anti-GBM disease (Goodpasture syndrome): "can cause pulmonary haemorrhage and death if not treated quickly" [7]
- ANCA-associated vasculitis (GPA, MPA, EGPA)
- Lupus nephritis (Class III/IV)
- IgA nephropathy (severe crescentic form)
- Presents with nephritic syndrome: haematuria, proteinuria, hypertension, oedema, oliguria [10]
- RBC casts in urine are highly specific for glomerular disease
Definition: Obstruction of urinary outflow. Must be bilateral (or unilateral in a single functioning kidney) to cause significant AKI [6].
Pathophysiology: Obstruction → increased intratubular pressure → opposes glomerular filtration → GFR drops. Prolonged obstruction → tubulointerstitial fibrosis (irreversible intrinsic renal disease) [6].
| Level of Obstruction | Examples |
|---|---|
| Prostate | BPH, carcinoma of prostate [6] |
| Bladder | Bladder neck tumour, neurogenic bladder [6] |
| Ureter | Urinary stones (bilateral), retroperitoneal fibrosis (rare), pelvic malignancy (cervix, rectum) [6] |
| Urethra | Stricture, blocked catheter [6] |
Post-renal causes are important to recognize because they are often rapidly reversible [6] — relieving obstruction (e.g., urinary catheter for BPH, nephrostomy for ureteric obstruction) can restore kidney function.
Clinical Pearl — Blocked Catheter
A common ward scenario: a post-operative patient develops oliguria and rising creatinine. Before panicking about intrinsic renal disease, always check the catheter is patent — flush it, check for kinks, ensure drainage bag is not full.
Distinguishing Pre-Renal from Intrinsic Renal AKI
| Parameter | Pre-Renal | Intrinsic (ATN) |
|---|---|---|
| FENa | < 1% | > 2% |
| Urine Na | < 20 mmol/L | > 40 mmol/L |
| Urine osmolality | > 500 mOsm/kg | ~300 mOsm/kg (isosthenuria) |
| Urine specific gravity | > 1.020 | ~1.010 |
| BUN:Cr ratio | > 20:1 | < 15:1 |
| Urine sediment | Bland / hyaline casts | Muddy brown granular casts (ATN), RBC casts (GN), WBC casts (AIN) |
| Response to fluid | Improves with resuscitation | Does not improve |
FENa Caveats
FENa is unreliable in patients on diuretics (which increase Na excretion even in pre-renal states). In this situation, use fractional excretion of urea (FEUrea) instead: < 35% suggests pre-renal. Also, FENa may be < 1% in certain intrinsic renal conditions: contrast nephropathy, pigment nephropathy (rhabdomyolysis/haemolysis), early sepsis-related AKI, and acute GN.
7. Specific Aetiologies (Focus on Hong Kong)
AKI in the context of liver disease is a poor prognostic marker — the patient may be dead in the coming future [8].
- Occurs in advanced cirrhosis with portal hypertension
- Pathophysiology: Splanchnic vasodilation → reduced effective circulating volume → intense renal vasoconstriction → AKI despite structurally normal kidneys
- Hepatorenal syndrome is NOT the most common cause of AKI in liver disease — pre-renal (dehydration, over-diuresis, GI bleeding) and intrinsic renal (ATN from sepsis) are more common [8]
- Diagnosed by exclusion (no improvement with volume resuscitation, no shock, no nephrotoxins, no proteinuria, no structural renal disease)
sCr ↑ ≥ 25% from baseline OR ↑ 44 μmol/L within 48–72 hours after contrast exposure [11].
- Risk factors: renal impairment, diabetes, dehydration [12]
- GFR < 30: contraindicated for contrast; GFR 30–60: adequate hydration (IV NS), N-acetylcysteine PO 600 mg BD 1 day before and after procedure, avoid ACEI/ARB, diuretics, NSAIDs [11]
- May result in metformin retention → fatal lactic acidosis → MUST STOP METFORMIN BEFORE CONTRAST CT [12]
- Usually self-limiting (peaks at day 3–5, resolves by 1–2 weeks)
Dark brown urine, urine microscopy: myoglobin and pigmented granular casts (no RBCs), ↑↑ CK, ↑ K⁺, ↓ Ca²⁺, ↑ PO₄, ↑ urate, DIC, AKI [11].
- Causes: trauma (crush injury), seizures, statins, hypothyroidism/hyperthyroidism [11]
- Pathophysiology: myoglobin released from damaged muscle → precipitates in tubules (especially in acidic pH) → direct tubular toxicity + tubular obstruction → ATN
- Management: aggressive IV NS (1.5 L/h until stable), target UO 300 mL/h, alkalinize urine (NaHCO₃ to keep urine pH > 6.5), mannitol (keep plasma osmolar gap < 55), allopurinol if uric acid > 476, haemodialysis if refractory [11]
| Drug | Mechanism | Type |
|---|---|---|
| Aminoglycosides | Direct tubular toxicity | ATN (nephrotoxic) [9] |
| NSAIDs | Afferent arteriole constriction (↓ prostaglandins), AIN, papillary necrosis | Pre-renal / AIN / ATN [9] |
| ACEI/ARBs | Efferent arteriole dilation → ↓ GFR | Pre-renal (functional) |
| Calcineurin inhibitors (cyclosporine, tacrolimus) | Renal vasoconstriction, vascular calcification | Pre-renal / ATN / CKD [9] |
| Cisplatin | Direct tubular toxicity | ATN + tubular dysfunction (hypoK, hypoMg) [9] |
| PPIs | Acute tubulointerstitial nephritis | AIN → AKI; chronic → CKD [9] |
| PD-1 inhibitors | Acute tubulointerstitial nephritis | AIN → AKI [9] |
| Contrast agents | Direct tubular toxicity + renal vasoconstriction | ATN |
- Sepsis is the most common cause of AKI in ICU [13]
- Pathophysiology: multifactorial — systemic vasodilation (↓ renal perfusion), microvascular dysfunction (endothelial injury, microthrombi), direct tubular injury from inflammatory mediators (TNF-α, IL-1, IL-6), mitochondrial dysfunction
- Presents as part of multiple organ dysfunction syndrome (MODS) [13]
- Renal manifestation of sepsis: acute tubular necrosis / acute kidney injury [13]
- Occurs after chemotherapy for high-tumour-burden malignancies (e.g., acute leukaemia, Burkitt lymphoma)
- Pathophysiology: rapid cell death → release of intracellular contents → ↑ K⁺, ↑ PO₄, ↑ urate, ↓ Ca²⁺, ↑ LDH [14]
- Uric acid + calcium phosphate crystals precipitate in tubules → AKI
- Prevention: allopurinol/febuxostat (xanthine oxidase inhibitors), rasburicase (recombinant urate oxidase — contraindicated in G6PD deficiency), aggressive hydration [14]
8. Clinical Features
AKI is associated with progressive kidney damage, declining GFR, increased risk of complications, and mortality. Many ICU patients require nephrology consult because critical illness involves the kidney [3].
The clinical features of AKI are a direct consequence of the loss of kidney functions:
- Excretory function (waste clearance) → uraemia
- Regulatory function (fluid, electrolytes, acid-base) → fluid overload, electrolyte disturbances, metabolic acidosis
- Endocrine function (EPO, vitamin D, RAAS) → anaemia (if prolonged), hypertension
| Symptom | Pathophysiological Basis |
|---|---|
| Oliguria or anuria | ↓ GFR → ↓ urine production. Oliguria (< 0.5 mL/kg/h or < 400 mL/day) is often the earliest clinical sign of AKI |
| Peripheral oedema / facial puffiness | ↓ renal Na⁺ and water excretion → positive fluid balance → interstitial fluid accumulation. Periorbital oedema is particularly noticeable in the morning (gravity-dependent redistribution during sleep) |
| Dyspnoea | Fluid overload → pulmonary oedema. Also metabolic acidosis → compensatory Kussmaul breathing (deep, sighing respirations) |
| Nausea, vomiting, anorexia | Uraemia — accumulation of nitrogenous waste products (urea, creatinine, indoles, phenols) causes gastrointestinal irritation and central effects on the chemoreceptor trigger zone |
| Malaise / fatigue | Multifactorial: uraemia, acidosis, anaemia (if prolonged), electrolyte disturbance |
| Confusion / altered mental status | Uraemic encephalopathy — nitrogenous waste products cross the blood-brain barrier; also hyponatraemia, hyperkalaemia can contribute |
| Pruritus (itching) | Uraemic pruritus — deposition of calcium-phosphate crystals in skin, retained uremic toxins |
| Hiccups | Uraemia — irritation of the phrenic nerve or diaphragm |
| Muscle cramps | Electrolyte disturbances (especially hypocalcaemia, hyperkalaemia) |
| Dark/cola-coloured urine | Myoglobinuria (rhabdomyolysis), haemoglobinuria (haemolysis) |
| Flank/loin pain | Post-renal obstruction (stones, clot), renal capsule distension (acute GN), pyelonephritis |
| Symptoms of the underlying cause | E.g., chest pain (MI causing cardiogenic shock → pre-renal AKI), fever/rigors (sepsis), joint pain/rash (SLE/vasculitis) |
| Sign | Pathophysiological Basis |
|---|---|
| Hypertension | ↓ Na⁺ and water excretion → volume expansion → ↑ BP. Also RAAS activation. Can be severe enough to cause hypertensive emergency |
| Peripheral oedema (pitting) | Fluid overload → interstitial fluid accumulation |
| Elevated JVP | Volume overload → ↑ central venous pressure. Key bedside sign to distinguish fluid-overloaded from dehydrated patients |
| Pulmonary crepitations / crackles | Pulmonary oedema (cardiogenic due to volume overload) |
| Kussmaul breathing | Deep, laboured breathing as respiratory compensation for metabolic acidosis (loss of renal H⁺ excretion and HCO₃⁻ regeneration) |
| Asterixis (flapping tremor) | Uraemic encephalopathy — metabolic flapping tremor (also seen in hepatic encephalopathy, hypercapnia) |
| Pericardial friction rub | Uraemic pericarditis — direct irritation of pericardium by uraemic toxins. This is an indication for emergency dialysis |
| Signs of volume depletion (if pre-renal) | Dry mucous membranes, ↓ skin turgor, tachycardia, hypotension, ↓ JVP, postural hypotension [6] |
| Palpable bladder | Post-renal obstruction (e.g., BPH, neurogenic bladder). Perform bladder scan / catheterize [6] |
| Abdominal bruits | Renal artery stenosis (may cause pre-renal or renovascular AKI) |
| Livedo reticularis / blue toes | Cholesterol crystal embolization (atheroembolic disease) — classically post-vascular procedure |
| Rash + fever | Drug-induced AIN (classic triad: fever, rash, eosinophilia) [7]; also vasculitis (purpura), SLE (malar rash) |
| Muscle tenderness | Rhabdomyolysis — tender, swollen muscles, ± compartment syndrome |
Diagnosis of Renal Diseases — Clinical Features to Look For
Oliguria or anuria, haematuria, proteinuria, oedema, hypertension, loin pain — these are the cardinal clinical manifestations that should prompt you to investigate for renal disease [7].
Acute kidney injury in liver disease is a poor prognostic marker [8].
- Diagnosis: KDIGO criteria — ↑ ≥ 50% Cr in 7 days OR ≥ 26.5 μmol/L Cr in 48 hours [8]
- Must separate causes: pre-renal, renal, and post-renal — every possible cause of AKI can occur in liver disease [8]
- Hepatorenal syndrome sounds like the obvious diagnosis but is actually not the most common cause [8]. Pre-renal causes (over-diuresis, GI bleeding, sepsis) are more frequent.
The modern conceptual model views AKI as a continuum: from normal kidney function → increased risk → kidney damage → decreased GFR → kidney failure → death. At each stage, there is potential for either recovery or progression [1][3].
Key points:
- Even mild AKI can transition to CKD [3] — the kidney may not fully recover, leading to permanent nephron loss
- Risk factors → susceptibility → exposure → injury → altered function → kidney failure → this progression model emphasises that AKI is preventable at early stages
High Yield — AKI to CKD Transition
An episode of AKI, even if apparently fully recovered, increases the long-term risk of developing CKD, ESKD, and cardiovascular events. This is because subclinical tubular injury → maladaptive repair → interstitial fibrosis → permanent nephron loss. Always follow up patients after AKI episodes.
Must monitor kidney function for many drugs — metformin, ACEI/ARB [9].
Key drug classes and their renal effects:
| Drug | Renal Effect | Clinical Implication |
|---|---|---|
| Aminoglycosides | AKI (direct tubular toxicity) | Monitor trough levels; dose-adjust for GFR [9] |
| Calcineurin inhibitors | Vascular calcification, AKI, CKD | Monitor drug levels and RFT regularly [9] |
| Cisplatin | Tubular disease (hypoK, hypoMg) | Hydration protocol essential [9] |
| NSAIDs | Pre-renal AKI, AIN, nephrotic syndrome, papillary necrosis | Nephrologists seldom use this — if you must, closely monitor RFT [9] |
| PPIs | Acute TIN → AKI; Chronic TIN → CKD | Consider de-prescribing when not indicated [9] |
| PD-1 inhibitors | Acute TIN → AKI | Increasingly common with expansion of immunotherapy [9] |
| Metformin | Lactic acidosis if accumulates in AKI | Withhold if AKI develops; must stop before contrast [12] |
| ACEI/ARBs | Functional pre-renal AKI (↓ efferent tone) | Withhold in acute illness ("sick day rules") |
High Yield Summary
Definition: AKI = abrupt ↓ kidney function. KDIGO 2012: ↑ Cr ≥ 26.5 μmol/L in 48h, OR ↑ Cr ≥ 1.5× baseline in 7d, OR UO < 0.5 mL/kg/h for 6h.
Staging: 3 stages (KDIGO) based on Cr rise and UO — Stage 3 includes Cr ≥ 3× or ≥ 353.6 μmol/L or RRT initiation.
Aetiology: Pre-renal ( > 50%) — hypovolaemia, ↓ CO, vasodilation; Intrinsic renal ( < 50%) — ATN (ischaemic/toxic), AIN, GN, vascular; Post-renal ( < 10%) — obstruction (must be bilateral).
Risk factors: Age > 50, pre-existing CKD, DM, HF, liver disease, sepsis, post-op, nephrotoxic drugs.
Clinical features: Oliguria, oedema, HTN, electrolyte disturbance (↑K, acidosis), uraemia (N/V, confusion, pericarditis, asterixis).
Key distinctions: Pre-renal (FENa < 1%, concentrated urine, responds to fluids) vs. ATN (FENa > 2%, muddy brown casts, does not respond to fluids).
AKI → CKD transition: Even mild AKI can lead to permanent nephron loss and CKD.
Drug-related AKI is common and preventable — always review the drug chart in any patient with AKI.
Active Recall - Acute Kidney Injury (Definition to Clinical Features)
[1] Lecture slides: Nephrology - Acute kidney injury.pdf (p4 - Definition & Classification objectives) [2] Senior notes: learning_points_output.txt (Nephrology section - AKI terminology evolution) [3] Senior notes: Block A - Glomerular and Tubulo-interstitial Diseases and Acute Kidney Injury.pdf (p30, p33 - AKI definition, conceptual model, risk factors) [4] Senior notes: Adrian Lui Pediatrics Notes.pdf (p329 - KDIGO definition, staging, pRIFLE) [5] Senior notes: Block A - Introduction to Renal Investigations (RFT, urine tests and US kidneys).pdf (p1 - AKI criteria, KDIGO staging, Hong Kong context) [6] Senior notes: Ryan Ho Critical Care.pdf (p25-26 - AKI aetiology table, clinical features, immediate approach) [7] Senior notes: Block A - Nephrotology Teaching Clinic RTD.pdf (p1, p3, p7 - ATN, AIN, kidney anatomy, clinical course) [8] Senior notes: Block A - Abdominal distension_ ascites and cirrhosis.pdf (p20 - AKI in liver disease, HRS) [9] Senior notes: Block A - Chronic Kidney Disease and its Complications.pdf (p12 - Drug-induced kidney disease) [10] Senior notes: Block A - Nephrology Interactive Tutorial.pdf (p1 - Nephritic syndrome presentation) [11] Senior notes: Maksim Medicine Notes.pdf (p218 - Rhabdomyolysis, contrast nephropathy) [12] Senior notes: Ryan Ho Diagnostic Radiology.pdf (p38 - Contrast nephrotoxicity, metformin) [13] Senior notes: MBBS Final MB (Surgery) (Felix PY Lai).pdf (p36 - Sepsis and MODS) [14] Senior notes: Block A - High white cell count_ acute and chronic leukaemia; bone marrow transplantation; immunogenetics.pdf (p16 - Tumour lysis syndrome)
Differential Diagnosis of Acute Kidney Injury
When you encounter a patient with rising creatinine or falling urine output, you are not "diagnosing AKI" — AKI is the syndrome. Your real job is to find the cause. The differential diagnosis of AKI is structured around the classic anatomical framework: where along the path from renal artery to urethra has the problem occurred?
Causes can be categorized into: pre-renal, intra-renal, and post-renal [15][16].
This is not just a neat classification — it has immediate therapeutic implications. Recognizing pre- and post-renal disease is particularly important because these are often rapidly reversible compared to renal intrinsic disease [6]. If you miss a post-renal obstruction or fail to resuscitate a pre-renal patient, you allow a reversible cause to progress to irreversible structural damage (ATN or tubulointerstitial fibrosis).
However, prolonged pre-renal and post-renal disease will progress to become ATN and tubulointerstitial fibrosis respectively, i.e. intrinsic renal disease [6].
Pre-renal AKI = the kidney is structurally normal but underperfused. Think of it as the kidney "thirsting for blood." The tubules are intact, so they do what they are supposed to do in hypovolaemia: reabsorb sodium and water avidly.
| Sub-category | Mechanism | Examples |
|---|---|---|
| True hypovolaemia | Absolute ↓ intravascular volume | Dehydration (vomiting, diarrhoea), haemorrhage, burns, 3rd-space losses (bowel obstruction, pancreatitis), trauma or major surgery [6] |
| Reduced cardiac output | Pump failure → ↓ renal perfusion pressure | Cardiogenic shock, acute heart failure, massive PE, cardiac tamponade |
| Systemic vasodilation | ↓ effective arterial blood volume despite normal or ↑ total volume | Sepsis (most common cause of AKI in ICU), anaphylaxis, liver failure / hepatorenal syndrome [6][8] |
| Renal vasoconstriction | Afferent arteriolar constriction → ↓ GFR | NSAIDs (inhibit prostaglandin-mediated afferent dilation), calcineurin inhibitors (cyclosporine, tacrolimus), contrast agents [6][9] |
| Efferent arteriole dilation | ↓ intraglomerular pressure → ↓ GFR | ACEI / ARBs — normally nephroprotective in CKD, but in acute hypovolaemia they remove the kidney's compensatory mechanism [6] |
Why pre-renal is so common: Most hospitalized patients are elderly with reduced renal reserve, on multiple medications (ACEI/ARB, diuretics, NSAIDs), and prone to dehydration (poor oral intake, vomiting, diarrhoea) or sepsis. This is the "perfect storm" for pre-renal AKI.
The Triple Whammy
ACEI/ARB + Diuretic + NSAID = the classic drug combination precipitating pre-renal AKI. The ACEI/ARB dilates the efferent arteriole, the diuretic reduces intravascular volume, and the NSAID constricts the afferent arteriole. Together, they obliterate the kidney's ability to maintain GFR. Always check the drug chart!
2. Intrinsic Renal Causes ( < 50% of AKI)
The kidney parenchyma itself is damaged. This is further subdivided by which compartment of the nephron is primarily affected — this is critical because the urine sediment, clinical presentation, and management differ for each.
ATN is a medical condition involving the death of tubular epithelial cells that form the renal tubules of the kidneys. Common causes of ATN include low blood pressure and use of nephrotoxic drugs [7].
| Type | Examples | Key Distinguishing Features |
|---|---|---|
| Ischaemic ATN | Prolonged pre-renal state → shock (any type), TTP, HUS, DIC, vasculitis, hepatorenal syndrome [7] | History of preceding hypotension or shock; essentially a pre-renal cause that has "crossed the line" |
| Nephrotoxic ATN — Exogenous | Aminoglycosides, cisplatin, contrast agents, heavy metals [7][9] | Temporal relationship with drug/toxin exposure; aminoglycosides characteristically cause non-oliguric AKI [10] because they damage tubular concentrating ability without necessarily reducing GFR as severely |
| Nephrotoxic ATN — Endogenous | Myoglobin (rhabdomyolysis), haemoglobin (haemolysis), monoclonal immunoglobulin light chains (multiple myeloma) [7][17] | Dark/cola-coloured urine; dipstick positive for blood but microscopy negative for RBCs (because it's detecting myoglobin/haemoglobin, not actual red cells) |
The presence of "muddy brown casts" of epithelial cells found in the urine during urinalysis is pathognomonic for ATN [7].
Diagnosis is made by a FENa > 3% and presence of muddy casts in urinalysis [7].
Non-Oliguric AKI
Non-oliguric acute renal failure can occur with some drugs, particularly aminoglycosides [10]. Since aminoglycosides damage renal tubular cells and impair their ability to concentrate urine, these patients can have rising creatinine while still passing good volumes of dilute urine. Don't be falsely reassured by "good urine output" — always check the creatinine.
Light chain cast nephropathy (myeloma kidney): A specific and often-missed diagnosis. Light chain cast nephropathy occurs in 30–50% of patients with multiple myeloma. 90% of cases occur in patients > 50 years old (median age 70). Presentations include acute renal failure and proteinuria [17]. On renal biopsy: bright red tubular casts rimmed by macrophages on H&E; PAS-stain shows casts are only palely positive (not Tamm-Horsfall protein); immunohistochemistry demonstrates light chain restriction (kappa or lambda) [17].
Atypical back pain — consider (1) multiple myeloma and (2) bony metastasis of cancer. Also enquire about the medications the patient took recently — consider drug-induced AKI [18].
Drug sensitivity reaction: (1) fever, (2) rash, and (3) eosinophilia [7].
| Cause Category | Examples |
|---|---|
| Drug-induced (~70%) | Antibiotics (penicillins, cephalosporins, sulfonamides, rifampicin, co-trimoxazole), NSAIDs, PPIs, PD-1 inhibitors, allopurinol, anti-TB drugs [7][9][17] |
| Infection-related | Pyelonephritis, leptospirosis, CMV, EBV |
| Autoimmune | SLE, Sjögren's syndrome, sarcoidosis, IgG4-related disease |
TB drug-induced acute tubulointerstitial nephritis: 74-year-old lady started on anti-TB medications 10 days ago → fever, generalized rash, hepatosplenomegaly, lymphadenopathy, WBC 17800 with eosinophilia, serum creatinine 560 μmol/L, urinalysis shows WBC casts, renal US shows large echogenic kidneys [17].
Key point about NSAIDs and AIN: NSAIDs can cause a unique dual pathology — NSAID-induced nephrotic syndrome combines minimal change glomerulonephropathy with acute tubulointerstitial nephritis. Features: nephrotic syndrome, no RBCs in urine, AKI, eosinophilia (~40%). Higher risk in elderly [19]. This is a favourite exam question.
The glomerulus is the filtration barrier. When it is inflamed, you get the nephritic syndrome: haematuria, proteinuria, hypertension, oedema, oliguria [10].
Differential diagnosis of haematuria (from the GC lecture) [20]:
- Urologic conditions: stones, tumour
- Renal conditions: glomerulonephritis, acute interstitial nephritis, polycystic kidney disease
- Infection: cystitis, TB, schistosomiasis
The most feared glomerular cause of AKI is rapidly progressive glomerulonephritis (RPGN) — defined as a rapid decline in GFR over days to weeks with crescent formation on biopsy. This is a nephrological emergency.
| RPGN Category | Mechanism | Key Examples |
|---|---|---|
| Type I — Anti-GBM disease | Antibodies against the α3 chain of type IV collagen in the GBM | Goodpasture syndrome: anti-GBM antibody mediated GN. Medical emergency — antibodies cross-react with pulmonary alveolar basement membranes → pulmonary haemorrhage and death if not treated quickly. Usually occurs in older patients [7] |
| Type II — Immune complex | Deposition of immune complexes in glomeruli | Lupus nephritis (Class III/IV), IgA nephropathy (crescentic form), post-streptococcal GN, membranoproliferative GN |
| Type III — Pauci-immune | ANCA-associated small vessel vasculitis | GPA (Wegener's), MPA, EGPA (Churg-Strauss) |
When creatinine rises suddenly — e.g., from 126 to 355 μmol/L in 1 day (182% increase) — think RPGN [10].
The interactive tutorial case [10] — a 34-year-old Chinese lady with malaise, bilateral small joint pain, lower limb swelling, BP 152/92, urine RBC 3+ and protein 3+:
- This is a nephritic syndrome presentation
- Joint involvement + young female → think lupus nephritis (→ ask about hair loss, oral ulcers, photosensitive rash, Raynaud's)
- SLE can also cause distal RTA [10]
- Always ask about drug history (NSAIDs — possible given MSK complaints) [10]
- If rapid deterioration → RPGN — renal biopsy indicated [10]
| Condition | Mechanism |
|---|---|
| Thrombotic microangiopathy (TMA) | TTP, HUS, DIC — microthrombi in renal vasculature → ischaemic ATN [7] |
| Small vessel vasculitis | ANCA-associated vasculitis (overlaps with RPGN Type III) [6] |
| Renal artery stenosis / thrombosis | Acute occlusion → renal infarction |
| Aortic dissection involving renal arteries [6] | Dissection flap occludes renal artery ostium |
| Cholesterol crystal embolization | Post-vascular procedure in elderly; livedo reticularis, blue toes, eosinophilia |
| NSAID- or contrast-related renovascular [6] | Afferent vasoconstriction / direct toxic ATN |
| Hepatorenal syndrome [6][8] | Intense renal vasoconstriction in setting of advanced cirrhosis with splanchnic vasodilation |
| Microangiopathic haemolytic anaemia [6] | Mechanical shearing of RBCs in abnormal microvasculature → schistocytes on blood film |
Post-renal = obstruction of urinary outflow. Must be bilateral (or unilateral in a solitary kidney) to cause significant AKI [6].
| Level | Examples |
|---|---|
| Prostate | BPH, CA prostate [6] |
| Bladder | Bladder neck tumour, neurogenic bladder, blocked catheter [6] |
| Ureter | Urinary stones (bilateral), retroperitoneal fibrosis (rare), pelvic malignancy [6] |
| Urethra | Stricture, phimosis |
How to identify post-renal AKI:
- S/S: palpable enlarged bladder with ↑ residual volume, blocked catheter [6]
- USG kidneys: hydronephrosis, dilated collecting system [21]
- Management: directed to the underlying cause — catheterize, nephrostomy, stent [6]
Someone comes in with high creatinine with a normal-sized kidney — what are you worried about? Acute kidney injury → parenchymal, vascular kidney problems (e.g., glomerulonephritis). Will require a kidney biopsy [21].
Differential diagnosis of a large kidney: polycystic kidney disease, infiltration (amyloidosis — rarer), or obstruction (post-renal) [21].
Differential diagnosis of a small kidney: chronic kidney disease — dysplastic, scarred, or shrunken kidney [21].
High Yield — Kidney Size on Ultrasound
Normal kidney size: 10–12 cm, symmetrical [21]. In AKI, kidneys are usually normal-sized or even enlarged (e.g., AIN with interstitial oedema shows large echogenic kidneys [17]). Small kidneys suggest CKD, not AKI — this is a key distinguishing feature. If you find small kidneys in someone you thought had AKI, reconsider: this may be acute-on-chronic kidney disease or CKD that has been unrecognised.
The table below summarises the key discriminating features across the three categories:
| Feature | Pre-Renal | Intrinsic — ATN | Intrinsic — AIN | Intrinsic — GN | Post-Renal |
|---|---|---|---|---|---|
| History | Dehydration, bleeding, HF, sepsis, drugs (ACEI/ARB, NSAID, diuretic) | Preceding hypotension, nephrotoxic drug/toxin exposure | New drug started (especially antibiotics, PPIs, NSAIDs) | Joint pain, rash, haemoptysis, recent sore throat | Prostate symptoms, pelvic malignancy, stones, anuria alternating with polyuria |
| Urine output | Oliguria (usually) | Oliguric or non-oliguric | Variable | Oliguria, haematuria | Anuria (complete obstruction) or fluctuating |
| FENa | < 1% | > 2–3% | > 1% | Variable (often < 1% in GN) | Variable |
| Urine sediment | Bland, hyaline casts | Muddy brown granular casts [7] | WBC casts, eosinophiluria [7] | RBC casts (pathognomonic for GN), dysmorphic RBCs | Bland or crystals |
| Urine osmolality | > 500 mOsm/kg | ~300 mOsm/kg | Variable | Variable | Variable |
| Kidney size (US) | Normal | Normal | Large, echogenic [17] | Normal or slightly large | Hydronephrosis |
| Response to fluids | Improves | Does not improve | Does not improve | Does not improve | Does not improve (needs relief of obstruction) |
| Blood tests | ↑ BUN:Cr ratio > 20 | ↑ CK (rhabdo), ↑ LDH (TLS/haemolysis) | Eosinophilia, ↑ IgE | ↓ C3/C4, +ANA, +ANCA, +anti-GBM | ↑ PSA (prostate), ↑ Ca (malignancy) |
5. Differential Diagnoses by Specific Clinical Scenario
AKI in liver disease is a poor prognostic marker — patient may be dead in the coming future [8].
The differential in a cirrhotic patient with AKI:
- Pre-renal (most common): over-diuresis (too much spironolactone/furosemide for ascites), GI bleeding (variceal), diarrhoea (lactulose overdose), sepsis (SBP)
- Intrinsic: ATN from prolonged hypoperfusion or sepsis, drug-related (contrast, aminoglycosides)
- Hepatorenal syndrome: diagnosis of exclusion — no improvement after 48h albumin challenge (1 g/kg/day, max 100g), no shock, no nephrotoxins, no proteinuria > 500 mg/day, no structural renal disease on US
- Post-renal: rare but always exclude
Post-operative (e.g., post-CABG) is a risk factor for AKI [3][6].
Differential in a post-op patient with rising creatinine:
- Pre-renal: hypovolaemia (intra-operative blood loss, inadequate fluid replacement, third-space losses), reduced cardiac output (post-cardiac surgery), sepsis
- Post-renal: blocked catheter [6] — always check this first!
- Intrinsic: ATN from prolonged intra-operative hypotension, contrast (if intra-operative angiography), nephrotoxic drugs (aminoglycosides for prophylaxis)
Differential for AKI + dark/cola-coloured urine:
- Rhabdomyolysis: ↑↑↑ CK, pigmented granular casts, urine dipstick positive for blood but microscopy negative for RBCs [11]
- Haemolysis: intravascular haemolysis → haemoglobinuria, ↑ LDH, ↑ indirect bilirubin, ↓ haptoglobin, schistocytes if TMA
- Glomerulonephritis: "smoky" or "coca-cola" urine from macroscopic haematuria, RBC casts on microscopy
Young subjects are NOT expected to have AKI [3]. When they do, consider:
- Glomerulonephritis — especially IgA nephropathy (most common GN worldwide), lupus nephritis (young females), post-streptococcal GN (children/young adults)
- Drug/toxin exposure — recreational drugs, herbal medicines (aristolochic acid nephropathy — important in Hong Kong/Southern China)
- Rhabdomyolysis — intense exercise, seizures, stimulant drugs
- Light chain cast nephropathy — though classically in the elderly, the RTD case demonstrates a 35-year-old woman with AKI from light chain cast nephropathy due to multiple myeloma [17] — don't dismiss myeloma in younger patients if there is unexplained AKI and anaemia
A critical differential to recognise:
- Anti-GBM disease (Goodpasture syndrome) — medical emergency [7]
- ANCA-associated vasculitis (GPA, MPA)
- SLE (Class IV lupus nephritis + diffuse alveolar haemorrhage)
Most CKD in diabetics is from diabetic nephropathy. But if any of the following atypical features are present, you should suspect a non-diabetic renal disease causing the AKI/CKD:
[22]:
- Short duration of diabetes mellitus
- Absence of other microvascular complications (e.g., diabetic retinopathy, diabetic neuropathy)
- Presence of urine RBC or RBC casts → suggests GN, not diabetic nephropathy
- Rapid deterioration in renal function → suggests RPGN or other acute cause
- Significant ↓ GFR > 30% within 2–3 months of starting ACEI/ARB → should raise the possibility of renal artery stenosis [22]
Also enquire about the medications the patient took recently — consider drug-induced AKI [18].
This cannot be overemphasised. In every patient with AKI, go through the drug chart systematically:
| Drug Class | Renal Injury Pattern | Notes |
|---|---|---|
| Aminoglycosides | ATN (tubular toxicity) | Non-oliguric AKI characteristic [9][10] |
| NSAIDs | Pre-renal (↓ PG), AIN, nephrotic syndrome, papillary necrosis | "Nephrologists seldom use this — if you really have to, closely monitor kidney function" [9] |
| ACEI/ARBs | Functional pre-renal (efferent dilation) | Withhold during acute illness |
| Calcineurin inhibitors | Vascular calcification, AKI, CKD [9] | Dose-dependent; monitor levels |
| Cisplatin | Tubular diseases (hypoK, hypoMg) [9] | Pre-hydration protocol essential |
| PPIs | Acute TIN → AKI; Chronic TIN → CKD [9] | Increasingly recognised |
| PD-1 inhibitors | Acute TIN → AKI [9] | Rising prevalence with immunotherapy |
| Anti-TB drugs (rifampicin, isoniazid, pyrazinamide) | AIN [17] | Classic case: fever + rash + eosinophilia + ↑ Cr 10 days after starting TB treatment |
| Contrast agents | ATN (direct toxicity + vasoconstriction) | GFR < 30: contraindicated; GFR 30–60: hydrate + NAC [11] |
| Herbal medicines | Variable — AIN, ATN, chronic TIN | Aristolochic acid nephropathy — important in Hong Kong |
Not all AKI requires a biopsy. Biopsy is indicated when the cause is unclear and a tissue diagnosis will change management:
Renal biopsy is still essential for definitive diagnosis of a number of renal diseases: glomerulonephritis, tubulointerstitial diseases, vascular diseases, diseases in graft kidneys [7].
Specific indications:
- Suspected RPGN (rapidly rising creatinine with active sediment)
- Unexplained AKI with normal-sized kidneys [21]
- AIN not responding to drug withdrawal (to determine if steroids are warranted) [23]
- Suspected myeloma kidney [17]
- Atypical features of diabetic nephropathy [22]
Contraindications:
- Contracted/small kidneys (hard to target, may get only fibrous tissue) [5]
- Large cysts (cannot stop the bleeding) [5]
- Solitary kidney (no backup if complications occur) [5]
- Uncontrolled hypertension, bleeding diathesis
High Yield Summary
Approach: Always classify AKI into pre-renal ( > 50%), intrinsic renal ( < 50%), or post-renal ( < 10%).
Pre-renal: Most common overall. Hypovolaemia, ↓ CO, sepsis, drugs (NSAID, ACEI/ARB). FENa < 1%. Reversible with fluids.
Intrinsic — ATN: Most common intrinsic cause. Ischaemic (prolonged pre-renal) or nephrotoxic (drugs, pigments, light chains). Muddy brown casts. FENa > 2%.
Intrinsic — AIN: Drug-induced (antibiotics, PPIs, NSAIDs, PD-1 inhibitors). Classic triad: fever, rash, eosinophilia (but < 30%). WBC casts. Consider TB drugs in Hong Kong.
Intrinsic — GN/RPGN: Nephritic syndrome (haematuria, HTN, oedema). RBC casts. Anti-GBM, ANCA vasculitis, lupus nephritis. Medical emergency if RPGN.
Post-renal: < 10%. Must be bilateral obstruction. Check catheter. US shows hydronephrosis. Rapidly reversible.
Always review drugs. Always check kidney size on US. Always consider myeloma in elderly with unexplained AKI + anaemia.
Active Recall - Differential Diagnosis of AKI
References
[3] Senior notes: Block A - Glomerular and Tubulo-interstitial Diseases and Acute Kidney Injury.pdf (p30, p33) [5] Senior notes: Block A - Introduction to Renal Investigations (RFT, urine tests and US kidneys).pdf (p5) [6] Senior notes: Ryan Ho Critical Care.pdf (p25-26) [7] Senior notes: Block A - Nephrotology Teaching Clinic RTD.pdf (p1, p4, p8) [8] Senior notes: Block A - Abdominal distension_ ascites and cirrhosis.pdf (p20) [9] Senior notes: Block A - Chronic Kidney Disease and its Complications.pdf (p12) [10] Senior notes: Block A - Nephrology Interactive Tutorial.pdf (p1, p3) [11] Senior notes: Maksim Medicine Notes.pdf (p218) [15] Lecture slides: Introduction-kidney-Ix.pdf (p2) [16] Lecture slides: GC_Interactive tutorial (Nephr case 1) student copy.pdf (p1) [17] Senior notes: Block A - Nephrotology Teaching Clinic RTD.pdf (p15, p19, p35) [18] Senior notes: Block A - Nephrology Data Interpretation.pdf (p4) [19] Senior notes: Block A - Drugs and the Kidney.pdf (p14) [20] Lecture slides: GC 057. Glomerular and Tubulo-interstitial Diseases and Acute Kidney Injury.pdf (p16) [21] Senior notes: Block A - Chronic Kidney Disease and its Complications.pdf (p13) [22] Senior notes: Ryan Ho Urogenital.pdf (p85) [23] Senior notes: MBBS Final MB (Medicine) (Felix PY Lai).pdf (p925, p938, p1029)
Diagnostic Criteria, Algorithm & Investigations for Acute Kidney Injury
The diagnosis of AKI rests on two surrogate markers — serum creatinine and urine output. Neither directly measures kidney "injury"; they measure kidney function. This is an important conceptual point: you are detecting the consequence of injury (reduced filtration), not the injury itself.
AKI is common among hospitalized patients (~3–7%); can be up to 25–30% in ICU patients. Without prompt Dx and proper Mx, can progress to CKD/ESRD [15][24].
AKI can be diagnosed if any of the following is present (KDIGO criteria) [4][15][23][24][25]:
- ↑ sCr by ≥ 0.3 mg/dL (≥ 26.5 μmol/L) within 48 hours
- ↑ sCr to ≥ 1.5× baseline, which has occurred within the prior 7 days
- Urine volume < 0.5 mL/kg/h for 6 hours
Only one criterion needs to be met. These are OR criteria, not AND.
| Stage | Serum Creatinine | Urine Output |
|---|---|---|
| I | ↑ sCr to 1.5–1.9× baseline (> 50% increase) OR ↑ sCr ≥ 26.5 μmol/L | < 0.5 mL/kg/h for 6–12 hours |
| II | ↑ sCr to 2.0–2.9× baseline (> 100% increase) | < 0.5 mL/kg/h for ≥ 12 hours |
| III | ↑ sCr ≥ 3.0× baseline (> 200% increase) OR ↑ sCr ≥ 353.6 μmol/L (4.0 mg/dL) OR initiation of RRT OR eGFR < 35 in patients < 18 years | < 0.3 mL/kg/h for ≥ 24 hours OR anuria for ≥ 12 hours |
In Hong Kong we use μmol/L — whereas in other parts of the world they use mg/dL [5]. The conversion factor: 1 mg/dL = 88.4 μmol/L.
Limitations of Serum Creatinine as a Marker
Limitations of serum creatinine [11][23]:
- Does not accurately reflect GFR in patients who are not in a steady state — in early AKI, creatinine has not had sufficient time to accumulate, so sCr may still be low even when actual GFR is markedly reduced
- Creatinine is removed by dialysis — once dialysis is initiated, you cannot assess kidney function by measuring sCr
- GFR already dropped by ~50% when creatinine starts to rise — the hyperbolic relationship means small early drops in GFR barely change creatinine [4][5][10]
- Creatinine is affected by muscle mass (low in sarcopaenic elderly, high in muscular young men), diet (meat intake), and certain drugs (trimethoprim, cimetidine block tubular secretion of creatinine → falsely elevated)
Novel markers: NGAL (neutrophil gelatinase-associated lipocalin), cystatin C — currently under investigation as renal "troponins" [4][5].
The approach to AKI is simultaneously diagnostic and therapeutic — you treat reversible causes while investigating. This is not a linear pathway; many steps happen in parallel.
Ensure and manage ABC: "A dead person has no renal function" [6].
The algorithm follows a logical sequence: resuscitate → rule out post-renal → rule out pre-renal → investigate intrinsic renal → manage complications → consider dialysis.
High Yield — Immediate Approach to AKI (from GC and Senior Notes)
Immediate approach to AKI [6]:
- Ensure ABC — treat hypoxaemia with O₂, treat hypotension with aggressive fluid resuscitation. Takes time for UO to respond → do NOT give diuretics
- Consider and reverse pre-renal disease — S/S: dry mucosa, tachycardia, ↓CVP, ↓skin turgor, hypotension → Mx: fluid resuscitation
- Consider and reverse post-renal disease — S/S: palpable enlarged bladder with ↑ residual volume, blocked catheter → Mx: directed to underlying cause
- Consider and reverse use of any nephrotoxic drugs — NSAIDs, aminoglycosides, ACEI/ARB
- Manage life-threatening complications — fluid overload, hyperkalaemia, metabolic acidosis
- Workup and management of underlying causes
- Consider haemodialysis
3. Investigation Modalities — Detailed Guide
The investigations for AKI serve three purposes: (1) confirm the diagnosis and stage, (2) determine the cause (pre-renal vs. intrinsic vs. post-renal), and (3) identify and manage complications.
Diagnostic approach to renal diseases [18]:
- History taking: other comorbidities (DM, HT, SLE, streptococcal infection), drug history (penicillins, PPIs, NSAIDs, hydrochlorothiazide)
- Physical examination: ballottement of kidneys, bilateral pitting ankle oedema, café au lait complexion, BP measurement
- Investigations: blood tests, urine tests, imaging
| Investigation | What It Tells You | Key Findings & Interpretation |
|---|---|---|
| RFT: Urea, Creatinine, eGFR [5][18] | Confirms AKI and severity | Normal creatinine: ~65–100 μmol/L (age-dependent) [10]. When creatinine rises, GFR has already been reduced by at least 50% [10]. Trend is more important than a single value. |
| Urea:Creatinine ratio > 100 suggests pre-renal (urea is disproportionately reabsorbed in hypovolaemia) [11]. Ratio < 40 suggests ATN [11]. | ||
| Electrolytes: Na⁺, K⁺, Cl⁻, HCO₃⁻ [5] | Complications of AKI | Hyperkalaemia — most dangerous early complication. ECG changes at K > 6–7 mmol/L: tall peaked T waves; > 8: aberrant QRS; > 10: sine wave → VF [26]. |
| Metabolic acidosis — ↓ HCO₃⁻ (kidney fails to regenerate bicarbonate and excrete H⁺). Calculate anion gap (Na − Cl − HCO₃): if elevated → consider lactic acidosis, uraemia, ketoacidosis | ||
| Hyponatraemia — dilutional (fluid overload) or from true Na⁺ loss | ||
| CBP with differential | Underlying cause / complications | Anaemia → if normochromic normocytic, consider CKD (EPO deficiency) or haemolysis or myeloma. Eosinophilia → AIN, cholesterol embolism, vasculitis [7][17]. Thrombocytopaenia + schistocytes → TMA (TTP/HUS) |
| CRP / Procalcitonin | Infection / sepsis | Elevated in sepsis-driven AKI |
| CK (Creatine Kinase) | Rhabdomyolysis | ↑↑↑ CK (typically > 5× ULN) → rhabdomyolysis causing pigment nephropathy [11] |
| LDH | Haemolysis / TLS / TMA | ↑ LDH with ↑ indirect bilirubin, ↓ haptoglobin → intravascular haemolysis |
| Ca²⁺, PO₄³⁻, Urate | TLS, rhabdomyolysis, CKD-MBD | ↑K, ↑PO₄, ↑urate, ↓Ca → tumour lysis syndrome. ↑PO₄, ↓Ca → rhabdomyolysis (early) or CKD. Myeloma → ↑ Ca²⁺ (hypercalcaemia from osteolysis) |
| LFT | Hepatorenal syndrome, drug-induced liver injury | Hepatorenal syndrome requires evidence of liver cirrhosis. Drug-induced AIN may coexist with drug-induced hepatitis [23] |
| ABG | Acid-base status | Metabolic acidosis with ↑ anion gap → uraemia, lactic acidosis, DKA. Normal anion gap acidosis → consider RTA |
| Coagulation: PT/INR | DIC, liver disease | Prolonged in DIC (often accompanies sepsis-related AKI), liver failure |
| Blood cultures | Sepsis | Essential if infective cause suspected |
Autoimmune and Specific Screens — ordered when intrinsic renal disease (especially GN) is suspected:
| Investigation | What It Detects |
|---|---|
| ANA, anti-dsDNA, C3/C4 | Lupus nephritis — ↓ C3, ↓ C4, + ANA, + anti-dsDNA [23] |
| ANCA (p-ANCA / c-ANCA) | ANCA-associated vasculitis (MPA, GPA) |
| Anti-GBM antibodies | Anti-GBM disease (Goodpasture syndrome) — nephrological emergency [7] |
| HBV / HCV serology | HBV/HCV-associated GN. Urgent HBsAg if haemodialysis is anticipated [23] — infection control implications |
| ASO titre / anti-DNase B | Post-streptococcal GN |
| Serum/urine protein electrophoresis + immunofixation, serum free light chains | Multiple myeloma / light chain cast nephropathy [23][27] |
| Serum β₂-microglobulin | Myeloma staging / prognostication [27] |
| Complement levels (C3, C4) | ↓ C3 alone → post-infectious GN, MPGN, C3 glomerulopathy. ↓ C3 + ↓ C4 → SLE, cryoglobulinaemia |
When to Check Autoimmune Markers
Don't shotgun autoimmune tests on every AKI patient. Order them when: (1) there is active urine sediment (RBC casts, dysmorphic RBCs, proteinuria), (2) systemic features suggest autoimmune disease (rash, arthralgia, haemoptysis), (3) RPGN pattern (rapid creatinine rise with nephritic sediment), or (4) young patient with unexplained AKI. Workup for glomerulonephritis: many are immune-mediated, so use autoimmune markers [5].
The urine is your window into the kidney. Think of it as a "liquid biopsy."
Diagnosis of renal diseases for specific treatment: basic laboratory investigations include blood for RFT (urea and creatinine), urine for microscopy (red cells and white cells), and urine for quantification of protein (e.g., 24-hour urine for protein) [7].
| Investigation | What It Tells You | Key Findings |
|---|---|---|
| Urine dipstick | Screening for blood, protein, leukocytes, nitrites, glucose | Blood +ve → haematuria (GN) or myoglobin/haemoglobin (rhabdo/haemolysis). Protein +ve → glomerular disease or overflow proteinuria (myeloma). Leukocyte esterase/nitrites → UTI |
| Urine microscopy [7][11] | Identifies the compartment of injury | See detailed table below |
| Urine biochemistry: Na⁺, Cr, osmolality | Distinguishes pre-renal from ATN | FENa formula: (Urine Na × Plasma Cr) / (Plasma Na × Urine Cr) × 100 [7] |
| Urine protein quantification | Degree and type of proteinuria | 24-hour urine protein (gold standard but cumbersome) or spot urine protein:creatinine ratio (uPCR) — in QMH they use uPCR instead of UACR [5]. UACR (urine albumin:creatinine ratio) preferred for diabetic/CKD screening |
| Urine culture | UTI | Essential to exclude infection in all AKI patients |
Urine Microscopy — The Most Important Non-Invasive Test:
| Finding | Indicates | Mechanism |
|---|---|---|
| Muddy brown granular casts | ATN — pathognomonic [7] | Necrotic tubular epithelial cells embedded in Tamm-Horsfall protein. "Muddy brown" because the degenerate cells take on a dark, granular appearance |
| RBC casts | Glomerulonephritis | Red cells leak through damaged GBM → trapped in Tamm-Horsfall protein as they transit the tubule. Highly specific for glomerular disease |
| Dysmorphic RBCs | Glomerular haematuria [28] | RBCs are distorted by passage through the damaged GBM. Contrast with isomorphic RBCs (urological bleed — stones, tumour) |
| WBC casts | AIN, pyelonephritis [7][17] | Inflammatory cells infiltrate the interstitium → spill into tubules → form casts |
| Eosinophiluria | AIN (especially drug-induced) | Type IV hypersensitivity → eosinophil infiltration. Requires Hansel stain (Wright stain less sensitive). Sensitivity ~67%, so a negative result does NOT exclude AIN [7] |
| Hyaline casts | Pre-renal (concentrated urine) | Tamm-Horsfall protein casts without cellular elements. Non-specific |
| Crystals | Specific crystal nephropathy | Uric acid crystals (TLS), calcium oxalate (ethylene glycol poisoning), indinavir crystals |
| Myoglobin + pigmented granular casts, no RBCs | Rhabdomyolysis [11] | Myoglobin precipitates in tubules; dipstick detects haem but microscopy shows no RBCs |
Key Urine Biochemistry Table — Pre-Renal vs. ATN:
| Parameter | Pre-Renal | ATN | Why? |
|---|---|---|---|
| FENa | < 1% | > 2% (some say > 3%) [7][11] | Pre-renal: intact tubules avidly reabsorb Na⁺ (RAAS active). ATN: damaged tubules can't reabsorb Na⁺ |
| Urine Na | < 20 mmol/L | > 40 mmol/L [11] | Same reasoning |
| Urine osmolality | > 500 mOsm/kg | < 350 mOsm/kg [11] | Pre-renal: ADH maximally active → concentrated urine. ATN: concentrating ability lost (isosthenuria) |
| Plasma Urea:Cr ratio | > 100 | < 40 [11] | Urea is passively reabsorbed in PCT; in pre-renal states, slow tubular flow → more urea reabsorption → disproportionately high urea |
| Urine:Plasma Cr | > 40 | < 20 [11] | In pre-renal, creatinine is still secreted and concentrated. In ATN, impaired function → dilute urine |
| Urine:Plasma Urea | > 20 | < 10 [11] | Same principle as above |
FENa Pitfalls
FENa is unreliable in patients on diuretics — diuretics increase urinary Na excretion even in pre-renal states. Use FEUrea < 35% instead (urea handling is less affected by diuretics).
FENa may also be falsely low (< 1%) in certain intrinsic renal conditions: contrast nephropathy, pigment nephropathy (rhabdomyolysis/haemolysis), early sepsis-related AKI, and acute GN (because glomerular damage reduces filtration but tubules are still somewhat functional).
Hepatorenal Syndrome — Specific Urine Finding:
Spot urine sodium < 10 mmol/L is suggestive of HRS [8] — related to the excessive activation of the RAAS in splanchnic vasodilation. This is lower than typical pre-renal AKI (< 20) because the vasoconstriction is even more intense.
| Modality | Purpose | Key Findings |
|---|---|---|
| USG kidneys (first-line imaging) [5][21] | Exclude post-renal obstruction, assess kidney size, assess parenchymal echogenicity, Doppler for perfusion | Normal size: 10–12 cm, symmetrical [21]. Hydronephrosis → post-renal obstruction. Small kidneys → CKD, not AKI [21]. Large echogenic kidneys → AIN (interstitial oedema), amyloidosis, PCKD [17][21]. Normal-sized kidneys with ↑ Cr → worry about AKI (parenchymal/vascular) → will require biopsy [21] |
| USG Doppler | Assess renal perfusion | Renal artery stenosis, renal vein thrombosis |
| KUB X-ray [23] | Radiopaque stones, renal calcification | Quick screen for obstructing calculi |
| CT kidneys (non-contrast preferred) | Better delineation of obstruction, stones, masses | Non-contrast over contrast — use of contrast will harm kidneys [5]. CT with contrast only if absolutely necessary and with appropriate hydration protocols |
| CT angiography / MRA | Renal artery pathology | Renal artery stenosis, dissection, thrombosis |
| DTPA renogram | Renal perfusion and drainage | Useful for assessing differential function and drainage in obstructive uropathy |
| DMSA scan | Renal scarring | Identifies scarred/non-functioning segments (more relevant for CKD workup) |
MRI with Gadolinium — WARNING
MRI with gadolinium should be avoided in patients with AKI or severe CKD because gadolinium administration is associated with nephrogenic systemic fibrosis (NSF) [23] — a potentially severe and irreversible fibrosing condition of the skin and internal organs.
Renal biopsy is still essential for definitive diagnosis of a number of renal diseases [7]:
- Glomerulonephritis (MCD, FSGS, IgAN, membranous GN, MPGN)
- Tubulointerstitial diseases (acute tubular injury, tubulointerstitial nephritis)
- Vascular diseases (thrombotic microangiopathy, ANCA-associated vasculitis)
- Diseases in graft kidneys (rejection, infection, PTLD)
When to biopsy:
- Renal biopsy indicated if creatinine is markedly elevated or worsened over a course of days — provides definitive tissue diagnosis and allows therapeutic intervention to prevent ESRD [23]
- Consider if pre-renal cause or ATN unlikely, or persistent oliguria > 6 weeks [11]
- Suspected RPGN (crescent formation on biopsy is diagnostic)
- AIN not responding to drug withdrawal (to decide on steroids) — renal biopsy is usually required to confirm the diagnosis of AIN [7]
- Unexplained AKI with normal-sized kidneys [21]
- Suspected light chain cast nephropathy / myeloma kidney [17]
- Atypical features of diabetic nephropathy (RBC casts, rapid decline, no retinopathy) [22]
Procedure:
- Patient prone, radiologist uses US to find position, lower pole of kidney targeted, a few extractions (cores) taken for sufficient tissue [5]
- Tissue sent for: light microscopy, immunofluorescence (IF), and electron microscopy (EM) — the "triple stain" approach
Contraindications:
- Contracted/small kidneys — hard to target, may only get fibrous tissue [5]
- Large cysts — cannot control bleeding [5]
- Solitary kidney — no backup if complications occur [5]
- Uncontrolled hypertension (↑ bleeding risk)
- Bleeding diathesis (↑ INR, ↓ platelets)
Histopathological Findings in Specific Conditions:
| Condition | Key Histopathological Features |
|---|---|
| ATN | Tubulorrhexis — localized necrosis of tubular epithelial lining with focal rupture or loss of basement membrane [7] |
| AIN | Intense interstitial inflammation with infiltration of tubules and interstitium by polymorphonuclear leukocytes and lymphocytes. Eosinophils may be observed, especially in drug-induced AIN. Glomeruli and blood vessels are spared [7][23] |
| Light chain cast nephropathy | Tubular casts rimmed by macrophages on H&E, palely PAS-positive (not Tamm-Horsfall protein), kappa or lambda light chain restriction on immunohistochemistry [17] |
| Anti-GBM disease | Linear IgG deposits along GBM on IF; crescents on LM |
| ANCA vasculitis | Pauci-immune (little or no IF staining); necrotizing crescentic GN |
| Lupus nephritis | "Full house" IF pattern (IgG, IgA, IgM, C3, C1q); mesangial, subendothelial, or subepithelial deposits depending on class |
Essential in all AKI patients because of the risk of hyperkalaemia:
ECG changes of hyperkalaemia [26]:
- K 6–7 mmol/L: Tall, peaked ("tented") T waves
- K 7–8 mmol/L: Flattened P waves, prolonged PR interval
- K 8–10 mmol/L: Widened QRS complexes
- K > 10 mmol/L: Sine wave pattern → ventricular fibrillation → cardiac arrest
Always perform an ECG before the lab K result comes back if you clinically suspect hyperkalaemia — the ECG changes may be present before the blood result is available.
- Pulmonary oedema — bilateral perihilar opacification ("bat-wing" pattern), Kerley B lines, pleural effusions → confirms fluid overload
- Cardiomegaly — if heart failure is the cause of pre-renal AKI
- Bilateral pulmonary infiltrates/haemorrhage → pulmonary-renal syndrome (anti-GBM, ANCA vasculitis)
Anuria (< 50 mL/day) has a specific narrow differential [11]:
- Complete urinary tract obstruction
- Bilateral renal artery occlusion
- Acute cortical necrosis
- Rapidly progressive glomerulonephritis
Anuria is NOT typical of ATN (which usually has some urine output, even if reduced). If a patient is truly anuric, always consider obstruction first (simple catheterisation + US), then bilateral vascular catastrophe or RPGN.
This is a practical question on every ward: is this high creatinine new (AKI), old (CKD), or new-on-old (acute-on-chronic)?
| Feature | AKI | CKD |
|---|---|---|
| Previous Cr | Normal or near-normal baseline | Previously elevated |
| Kidney size on US | Normal (10–12 cm) or large | Small (< 9 cm) [21] |
| Parenchymal echogenicity | Normal or slightly increased | Increased (loss of cortico-medullary differentiation) [5] |
| Anaemia | Usually absent (unless haemolysis/bleeding) | Present — normochromic normocytic (↓ EPO) [9] |
| Bone profile | Usually normal | Abnormal — ↑ PTH, ↓ Ca, ↑ PO₄ (CKD-MBD) [9] |
| Renal osteodystrophy | Absent | May be present (subperiosteal erosions, rugger-jersey spine) |
How to differentiate acute vs. chronic kidney disease? Look for relevant metabolic abnormalities (metabolic acidosis) and electrolyte disturbances (hyperkalaemia) in blood tests, and kidney size on imaging [18].
High Yield Summary
Diagnostic criteria: KDIGO 2012 — any ONE of: ↑ Cr ≥ 26.5 μmol/L in 48h, ↑ Cr ≥ 1.5× in 7d, or UO < 0.5 mL/kg/h for 6h. Three stages based on severity.
Cr limitations: Insensitive early (GFR already ↓50%); unreliable on dialysis; affected by muscle mass. NGAL and cystatin C are emerging biomarkers.
Algorithm: ABC → Exclude post-renal (catheter, US) → Assess volume (pre-renal?) → Fluid challenge → If no improvement: investigate intrinsic → Review drugs → Manage complications → Consider dialysis (AEIOU).
Key discriminating tests: FENa (< 1% pre-renal vs. > 2% ATN); urine sediment (muddy brown = ATN, RBC casts = GN, WBC casts = AIN); kidney size on US (normal/large = AKI, small = CKD).
Autoimmune screen when active sediment or systemic features: ANA, ANCA, anti-GBM, C3/C4, HBV/HCV. Protein electrophoresis if myeloma suspected.
Renal biopsy for: unexplained AKI with normal-sized kidneys, suspected RPGN, AIN not improving, myeloma kidney. Contraindicated: small kidneys, large cysts, solitary kidney.
Always do ECG (hyperkalaemia) and CXR (fluid overload) in every AKI patient.
Active Recall - AKI Diagnostic Criteria, Algorithm & Investigations
References
[4] Senior notes: Adrian Lui Pediatrics Notes.pdf (p329 - KDIGO definition, staging, pRIFLE) [5] Senior notes: Block A - Introduction to Renal Investigations (RFT, urine tests and US kidneys).pdf (p1, p5) [6] Senior notes: Ryan Ho Critical Care.pdf (p25-26) [7] Senior notes: Block A - Nephrotology Teaching Clinic RTD.pdf (p1, p3, p4, p8) [8] Senior notes: Block A - Abdominal distension_ ascites and cirrhosis.pdf (p20, p22) [9] Senior notes: Block A - Chronic Kidney Disease and its Complications.pdf (p12, p13) [10] Senior notes: Block A - Nephrology Interactive Tutorial.pdf (p3) [11] Senior notes: Maksim Medicine Notes.pdf (p216) [15] Lecture slides: Introduction-kidney-Ix.pdf (p4) [17] Senior notes: Block A - Nephrotology Teaching Clinic RTD.pdf (p15, p19, p35) [18] Senior notes: Block A - Nephrology Data Interpretation.pdf (p1) [21] Senior notes: Block A - Chronic Kidney Disease and its Complications.pdf (p13) [22] Senior notes: Ryan Ho Urogenital.pdf (p85) [23] Senior notes: MBBS Final MB (Medicine) (Felix PY Lai).pdf (p925, p938, p1029) [24] Lecture slides: Nephrology - ntroduction to Renal Investigation.pdf (p4) [25] Lecture slides: GC 057. Glomerular and Tubulo-interstitial Diseases and Acute Kidney Injury.pdf (p60) [26] Senior notes: Ryan Ho Chemical Path.pdf (p14) [27] Senior notes: Block A - An old man with bone pain and anaemia_ multiple myeloma; monoclonal gammopathy.pdf (p20) [28] Senior notes: Ryan Ho Urogenital.pdf (p55)
Management of Acute Kidney Injury
Managing AKI is fundamentally about three simultaneous priorities happening in parallel, not sequentially:
- Resuscitate — keep the patient alive (ABC, treat life-threatening complications)
- Reverse — identify and correct the underlying cause
- Protect — prevent further renal injury and support recovery
Ensure and manage ABC: "A dead person has no renal function" [6].
The key mental model: AKI management = treat what you can reverse (pre-renal with fluids, post-renal with relief of obstruction, drug-related by stopping the drug) + support what you can't reverse (ATN — supportive care while tubules regenerate) + escalate when medical therapy fails (dialysis).
This happens the moment you identify AKI. Your first priority is to ensure the patient is haemodynamically stable.
Immediate approach to AKI [6]:
- Treat hypoxaemia by O₂ therapy
- Treat hypotension by aggressive fluid resuscitation
- Takes time for UO to respond → do NOT give diuretics
Why no diuretics initially? Because in a pre-renal patient, diuretics will worsen hypovolaemia and push them from reversible pre-renal AKI into irreversible ATN. The exception is the clearly fluid-overloaded patient with pulmonary oedema — here diuretics are essential (see below).
Step 2: Identify and Reverse the Cause
Consider and reverse post-renal disease: S/S — palpable enlarged bladder with ↑ residual volume, blocked catheter. Mx: directed to the underlying cause [6].
- Blocked catheter → flush or replace (this is the simplest and most commonly missed cause on the ward)
- BPH / prostate cancer → urethral catheterisation or suprapubic catheter
- Ureteric obstruction (stones, pelvic tumour) → percutaneous nephrostomy or retrograde ureteric stent (JJ stent)
- Obstruction should be relieved if present [29]
Watch for post-obstructive diuresis after relief — patients can become profoundly hypovolaemic from massive polyuria (the tubules temporarily cannot concentrate urine). Monitor UO closely and replace losses.
Fluid challenge: crystalloid solution (e.g., 500–1000 mL NS) given over 1–2 hours for hypovolaemia [23][29].
- For hypovolaemia: Fluid challenge with normal saline (NS) or balanced crystalloid solution (Plasma-Lyte), 500–1000 mL over 1–2 hours [29]
- Optimise pre-load [29] — reassess after the challenge. If creatinine starts to fall and UO improves, you've confirmed and treated pre-renal AKI.
- If no improvement after adequate fluid resuscitation → the problem has likely progressed to intrinsic renal disease (ATN)
- Low-dose dopamine is NOT recommended [29] — the concept of "renal-dose dopamine" has been debunked. It does not improve outcomes and may cause arrhythmias.
Fluid Choice in AKI
NS (0.9% saline) or balanced crystalloid (Plasma-Lyte, Ringer's lactate) are the first-line fluids. There is growing evidence that balanced crystalloids may cause less hyperchloraemic acidosis than large-volume NS, but NS remains widely used. Avoid colloids (starches — HES is nephrotoxic) and hypotonic fluids (cause hyponatraemia). Albumin is used in specific situations (HRS, SBP, large-volume paracentesis) but not as routine resuscitation fluid for AKI.
Consider and reverse use of any nephrotoxic drugs: NSAIDs, aminoglycosides, ACEI/ARB [6].
This is one of the most impactful interventions you can make. Go through the drug chart systematically:
| Drug to Stop | Why | Notes |
|---|---|---|
| NSAIDs | Afferent arteriole constriction → ↓ GFR; can also cause AIN, papillary necrosis | Nephrologists seldom use this — if you really have to use it, closely monitor kidney function [9] |
| ACEI / ARBs | Efferent arteriole dilation → ↓ intraglomerular pressure → ↓ GFR in acute setting | Never prescribe ACEI and ARB together. Contraindicated in bilateral renal artery stenosis [18] |
| Aminoglycosides | Direct tubular toxicity | If must continue (e.g., infective endocarditis), good hydration, adjust dose, serial monitoring, biomarkers of renal damage [19] |
| Metformin | Risk of lactic acidosis in AKI (reduced clearance) | Withhold until renal function recovers |
| Contrast agents | Direct tubular toxicity + vasoconstriction | Consider alternatives to radiocontrast procedures [29] |
| Calcineurin inhibitors | Renal vasoconstriction, vascular calcification, AKI, CKD [9] | Reduce dose or switch agent |
Drug prescribing in patients with impaired kidney function — 3 important principles: (1) avoid further nephrotoxic insult, (2) attention to correct dose, (3) beware of side-effects in patients with impaired kidney function [19].
2D. Treat Specific Intrinsic Causes
Management relies on aggressive treatment of the factors that precipitated ATN (e.g., hydration and cessation of offending drug) [7].
There is no specific pharmacological treatment for ATN — it is purely supportive. The tubular cells need time to regenerate (typically 1–3 weeks). Management:
- Maintain euvolaemia (not over- or under-hydrated)
- Correct electrolyte abnormalities
- Avoid further nephrotoxic insults
- Dialysis if complications develop (see below)
- Expect the clinical course: oliguric phase → diuretic phase (UO up to 3 L/day) → recovery phase [7]
Management for drug-induced tubulointerstitial nephritis: (1) stop the incriminated drug → usually patients get better. (2) Immunosuppression → usually not necessary, except for severe cases/systemic manifestations [19]:
- Drug-induced vasculitis
- Drug-induced mucocutaneous manifestations
- Immune checkpoint inhibitor-associated AKI
- Drug-induced hepatitis
For immune checkpoint inhibitor (PD-1 inhibitor)-associated AIN specifically:
Stop incriminating drug. Responsive to steroids → those not given steroids did not improve [19].
Steroids for AIN (when indicated): typically prednisolone 1 mg/kg/day (max 60 mg), tapered over 4–8 weeks after creatinine improves. Biopsy confirmation is usually sought before committing to steroids.
This requires urgent biopsy and immunosuppressive therapy — the specific regimen depends on the cause:
- Anti-GBM disease: plasma exchange (to remove circulating anti-GBM antibodies) + cyclophosphamide + high-dose corticosteroids
- ANCA vasculitis: cyclophosphamide (or rituximab) + corticosteroids; plasma exchange if severe (pulmonary haemorrhage or Cr > 500 μmol/L)
- Lupus nephritis (Class III/IV): mycophenolate mofetil (or cyclophosphamide) + corticosteroids + hydroxychloroquine
- Exclusion of other causes → since HRS is NOT the most common cause of AKI in liver disease
- Discontinue potential culprit drugs → diuretics, NS-BB etc.
- Treat infection
- IV albumin: 1 g/kg/day for 2 days, followed by 20–40 g/day [30]
- IV terlipressin: a vasopressin analogue which acts as a potent vasoconstrictor reducing splanchnic/systemic vasodilation → increase in MAP and effective arterial blood volume. Dosage: starts at 1 mg q4–6h, can be stepped up to 2 mg q4–6h (max 12 mg daily) if suboptimal response of serum creatinine [30]
Terlipressin contraindications: ischaemic heart disease, peripheral vascular disease, cerebrovascular disease [30].
Why terlipressin? In HRS, the fundamental problem is splanchnic vasodilation stealing blood flow from the kidneys. Terlipressin (a V1 receptor agonist) constricts the splanchnic vasculature, redirecting blood to the kidneys. Albumin expands the effective circulating volume.
HRS may recur after treatment discontinuation [8]. Renal replacement therapy is only a bridge to liver transplant. Liver transplantation is the definitive treatment [30].
- Aggressive IV NS (~100–200 mL/h) [11] — massive fluid resuscitation to flush myoglobin through the tubules
- Target UO 200–300 mL/h [11]
- Alkalinise urine with NaHCO₃ to keep urine pH > 6.5 [11] — myoglobin is less nephrotoxic at alkaline pH (prevents precipitation and Fenton reaction generating free radicals). Monitor ABG and Ca: stop if blood pH > 7.5 or symptomatic hypoCa [11]
- Mannitol (keep plasma osmolar gap < 55) [11] — osmotic diuretic to maintain tubular flow
- Allopurinol if uric acid > 476 [11]
- Haemodialysis if above measures fail [11]
- Look out for compartment syndrome [11] — may require fasciotomy
Step 3: Manage Life-Threatening Complications
These are managed simultaneously with cause identification. A patient can die from hyperkalaemia or pulmonary oedema before you've figured out the cause of AKI.
Symptoms (arrhythmia, weakness) usually only when K > 6 [6].
Emergency management of hyperkalaemia (in order of importance) [29][31]:
| Step | Treatment | Mechanism | Onset | Duration | Details |
|---|---|---|---|---|---|
| 1 | IV Calcium (10% calcium gluconate 10 mL over 2–3 min) | Cardioprotective — stabilises myocardial cell membrane by raising threshold potential | Within minutes | 30–60 min | Does NOT reduce serum K. Buys time. May repeat after 5 min if no effect on ECG [31] |
| 2 | IV NaHCO₃ infusion | Shifts K⁺ into cells by correcting acidosis | Within 30 min | Several hours | Especially useful if concurrent metabolic acidosis [31] |
| 3 | IV Insulin/Dextrose (10 units Actrapid in 50 mL D50%) | Insulin drives K⁺ into cells via Na⁺/K⁺-ATPase stimulation; dextrose prevents hypoglycaemia | Within 1 hour | 5–6 hours | 10 units to 3 gm glucose (60 mL D50) [31]. Monitor BSL hourly |
| 4 | Urgent haemodialysis | Most effective in removing K⁺ from the body | Takes time to set up | Until discontinued | Most effective but takes time to set up [31] |
Non-emergency (subacute) hyperkalaemia management [31]:
- Cation-exchange resins — Na/Ca polystyrene sulphonate (oral or enema) — bind K⁺ in the gut for faecal excretion. Newer agents: Lokelma (sodium zirconium cyclosilicate), Patiromer [31]
- Loop diuretic if not oliguric — increases renal K⁺ excretion
- Remove underlying cause — stop offending drugs (ACEI/ARB, K⁺-sparing diuretics, trimethoprim), volume expansion if depleted
- Correct metabolic acidosis
- Low K⁺ diet ( < 20 mmol/day) [23][29]
High Yield — IV Calcium in Hyperkalaemia
IV Calcium does NOT lower potassium levels. It protects the heart by stabilising the myocardial membrane. Students often mistake this for a potassium-lowering treatment — it is NOT. It is purely cardioprotective and buys you time to institute definitive K-lowering therapy (insulin/dextrose, dialysis). Always give calcium FIRST if ECG changes are present.
Metabolic acidosis: Kussmaul's breathing. Mx: IV bicarbonate, dialysis [6].
- Determine the cause and treat the underlying cause [31]
- IV NaHCO₃ — consider if pH < 7.2 or HCO₃⁻ < 10 mmol/L. This is a temporising measure, not definitive treatment
- Risks of NaHCO₃ therapy [31]:
- Hypernatraemia (1 mmol HCO₃⁻ carries 1 mmol Na⁺ — 200 mmol NaHCO₃ = more Na⁺ than 1 litre of NS)
- Induce hypoK (shifts K⁺ intracellularly — dangerous in patients with existing hypoK or DKA)
- Decrease ionised calcium (problematic if already hypocalcaemic from CKD/AKI)
- Volume expansion from Na⁺ load
- Paradoxical cerebral acidosis — HCO₃⁻ breaks down to CO₂, which crosses the BBB and is converted to acid by carbonic anhydrase
- Dialysis if refractory (pH < 7.1 despite bicarbonate)
Fluid overload: peripheral oedema, hypertension, pulmonary oedema. Mx: IV loop diuretics (e.g., furosemide), dialysis [6].
- For fluid overload: Add furosemide up to 80 mg IV bolus or 10 mg/h IV infusion [29]
- Consider to add metolazone 5–10 mg daily PO if refractory [29] — a thiazide-like diuretic that acts synergistically with loop diuretics ("sequential nephron blockade": metolazone blocks Na reabsorption in the DCT, so the distal tubule can't compensate for the loop diuretic's effect)
- Sit patient upright, give O₂
- If refractory → urgent dialysis/ultrafiltration
- Uraemic pericarditis — pericardial friction rub; indication for emergency dialysis (risk of haemorrhagic pericardial tamponade)
- Uraemic encephalopathy — confusion, asterixis, seizures; indication for dialysis
- Uraemic bleeding — platelet dysfunction from uraemic toxins; desmopressin (DDAVP) can temporarily improve platelet function; dialysis is definitive
Treatment of acute kidney injury [29]:
| Measure | Details | Rationale |
|---|---|---|
| Fluid intake | = 500 mL + volume of urine output; Assess any ongoing loss [29] | Insensible losses (~500 mL/day from skin/lungs) + replace measured output. Prevents both over- and under-hydration |
| Strict I/O chart | Daily body weight ( < 1 kg increase in BW per day) [23][29] | Weight gain > 1 kg/day suggests fluid accumulation |
| Low Na⁺ diet | < 100 mmol/day [23][29] | Reduces fluid retention |
| Low K⁺ diet | < 20 mmol/day [23][29] | Prevents further hyperkalaemia |
| Low PO₄³⁻ diet | < 800 mg/day [23][29] | Prevents hyperphosphataemia |
| Low protein diet | 40 g high biological value [23] | Reduces urea generation while maintaining essential amino acid intake. "High biological value" = animal protein containing all essential amino acids |
| Avoid nephrotoxic drugs | NSAID, aminoglycoside, etc. [23][29] | Prevents further renal injury |
| Consider alternatives to radiocontrast procedures [29] | US, MRI (without gadolinium) | Contrast is directly nephrotoxic |
| Consider renal biopsy | To ascertain the cause of AKI if the cause is not apparent [29] | Especially for suspected GN, AIN not responding, myeloma kidney |
Step 5: Renal Replacement Therapy (Dialysis)
Dialysis is the last resort when medical management fails. It does not treat the underlying cause — it buys time for the kidney to recover (or bridges to transplant in the case of HRS/ESRD).
Haemodialysis: last-resort treatment for renal support [6].
| Letter | Indication | Threshold / Details |
|---|---|---|
| A | Acidosis | Refractory metabolic acidosis with HCO₃⁻ < 10 mmol/L [23][32]; pH < 7.1 refractory to bicarbonate infusion [6] |
| E | Electrolyte disturbance | Uncontrolled hyperkalaemia > 6 mmol/L [23][32]; K > 6.5 or rapidly rising K refractory to medical Rx [6] |
| I | Intoxication | Drug removal in overdose: alcohol, NSAIDs, acetaminophen, metformin, lithium, ethylene glycol, methanol, salicylates [6][23][32] |
| O | Oedema (fluid Overload) | Refractory fluid overload / Uncontrolled pulmonary oedema [23][32]. Also: uncontrolled pulmonary oedema related to renovascular hypertension (chronic HTN + Na⁺/H₂O retention from RAAS activation) [23] |
| U | Uraemia | Uraemic pericarditis, uraemic encephalopathy, intractable uraemic symptoms (nausea, vomiting, neuropathy, ↓ mental status) [6][23][32] |
High Yield Exam Point — AEIOU
The AEIOU mnemonic for dialysis indications is extremely high yield for both written and clinical exams. The key principle: dialysis is indicated when a complication of AKI is refractory to medical management. You do not dialyse for a creatinine number alone — you dialyse for clinical complications.
| Modality | Description | When to Use |
|---|---|---|
| Intermittent haemodialysis (IHD) | Blood pumped through an extracorporeal circuit with a dialysis filter; solutes removed by diffusion across a semipermeable membrane; sessions typically 3–4 hours | Haemodynamically stable patients; efficient for rapid correction of hyperkalaemia or toxin removal |
| Continuous renal replacement therapy (CRRT) | Usually pumped venovenous haemofiltration (CVVH/CVVHDF) via central venous catheter [6] | ICU patients who are haemodynamically unstable — continuous, slow removal avoids the rapid fluid shifts that cause hypotension during IHD. Consider admission to ICU [6] |
| Peritoneal dialysis (PD) | Dialysis solution instilled into the peritoneal cavity; solutes and fluid removed across the peritoneal membrane | Rarely used for AKI in adults (more common for CKD maintenance). May be used in paediatric AKI or resource-limited settings |
Access for acute haemodialysis:
- Temporary vascular catheter — large-bore double-lumen catheter inserted into internal jugular vein (preferred), subclavian vein (avoid if possible — risk of central vein stenosis that precludes future AV fistula on that side), or femoral vein
- Not an AV fistula — fistulas take weeks to mature and are for chronic dialysis
Contraindications to PD [32]:
- Previous extensive abdominal surgery (scarring)
- Frequent PD-related peritonitis
- Residence that does not permit PD or lacks sanitary conditions
| Cause | Key Management |
|---|---|
| Pre-renal | Volume resuscitation (NS/crystalloid); stop offending drugs; treat underlying cause (sepsis → antibiotics, HF → inotropes/diuretics) |
| ATN | Supportive: hydration, stop offending agent [7]. No specific drug therapy. Wait for tubular regeneration |
| AIN | Stop incriminated drug → usually patients get better [19]. Steroids for severe/refractory cases (especially immune checkpoint inhibitor-associated AKI → responsive to steroids [19]) |
| RPGN / GN | Urgent biopsy → immunosuppression (cyclophosphamide/rituximab + steroids ± plasma exchange depending on type) |
| HRS | IV albumin + IV terlipressin; treat infection; discontinue diuretics/NS-BB. RRT as bridge to liver transplant [8][30] |
| Rhabdomyolysis | Aggressive IV NS, target UO 200–300 mL/h, alkalinise urine (NaHCO₃), allopurinol for hyperuricaemia, dialysis if refractory [11] |
| Tumour lysis syndrome | Aggressive hydration (3 L/m²/day), rasburicase (C/I in G6PD deficiency), correction of hyperK, ECG monitoring, RRT if necessary [33] |
| Contrast nephropathy | Prevention: GFR 30–60 → adequate hydration (IV NS), N-acetylcysteine, avoid ACEI/ARB, diuretics, NSAIDs [11]. Self-limiting if occurs |
| Post-renal | Relieve obstruction (catheterise, nephrostomy, JJ stent). Monitor for post-obstructive diuresis |
Why are the kidneys so susceptible to drug side effects? Renal tubular cells serve many functions, very metabolically active → many substances/metabolites will be concentrated within the kidney [19]. CKD increases the susceptibility of the kidney to further damage — increased susceptibility to both direct and indirect injury [19].
| Principle | Explanation |
|---|---|
| Avoid further nephrotoxic insult [19] | Stop NSAIDs, aminoglycosides, contrast, metformin, calcineurin inhibitors |
| Attention to correct dose [19] | Altered clearance ± increased susceptibility to adverse effects due to reduced renal function → adjust dosage and/or frequency [19] |
| Beware of side-effects in patients with impaired kidney function [19] | Ethambutol → optic neuritis; acyclovir, imipenem, INAH, quinolones → CNS side effects (seizures) at standard doses in AKI [19] |
Useful example: Linagliptin (Tradjenta) — a DPP-4 inhibitor with hepatobiliary elimination, no need to change dose according to renal function [19]. Most other DPP-4 inhibitors require dose adjustment in AKI/CKD.
Renoprotective Agents — Not for Acute AKI But Important Context
For patients with CKD (to prevent progression to ESRD) [10][19]:
- Proteinuria reduction: RAAS inhibition/blockade (ACEI/ARB)
- SGLT2 inhibitors → massive reduction in risk of renal failure
- Non-steroidal mineralocorticoid receptor antagonist → finerenone: reduces kidney fibrosis, more targeted than spironolactone/eplerenone, lower hyperK risk, can combine with ACEI/ARB
- GLP-1 receptor agonists → semaglutide (Ozempic)
- Optimal BP control, no smoking, vascular risk factor management
Note: ACEI/ARBs and SGLT2i should be withheld during acute AKI (risk of worsening renal function) but restarted once the patient has recovered, as they provide long-term renoprotection.
AKI doesn't end at hospital discharge. The kidney may not fully recover:
Even mild, reversible AKI can have important clinical consequences such as CKD transition [3].
- Check renal function 1–2 weeks after discharge, then at 3 months
- If creatinine has not returned to baseline → classify as CKD and manage accordingly
- Educate patients about "sick day rules" — temporarily stop ACEI/ARBs, metformin, diuretics, and NSAIDs during intercurrent illness (vomiting, diarrhoea, fever) to prevent recurrent AKI
- Avoid future nephrotoxic exposures where possible
High Yield Summary
Management framework: Resuscitate (ABC, fluids) → Reverse cause (post-renal → pre-renal → drug → intrinsic) → Manage complications (AEIOU) → Dialysis if refractory.
Pre-renal: NS 500–1000 mL over 1–2h. Low-dose dopamine NOT recommended.
Post-renal: Relieve obstruction. Watch for post-obstructive diuresis.
Drug-related: Stop all nephrotoxins (NSAIDs, aminoglycosides, ACEI/ARB, metformin, contrast).
ATN: Supportive only — hydration + stop offending agent. No specific drug therapy.
AIN: Stop drug. Steroids only if severe/refractory (especially checkpoint inhibitor AKI — responsive to steroids).
HRS: IV albumin (1 g/kg/day × 2 days) + IV terlipressin. RRT as bridge to liver transplant.
Rhabdomyolysis: Aggressive IV NS + urine alkalinisation + allopurinol + dialysis if refractory.
Hyperkalaemia: IV Ca (cardioprotective, does NOT lower K) → NaHCO₃ → insulin/dextrose → dialysis. Non-urgent: resins (Lokelma/Patiromer), loop diuretics.
Dialysis (AEIOU): Acidosis (pH < 7.1, HCO₃ < 10), Electrolytes (K > 6–6.5 refractory), Intoxication, Overload (refractory pulmonary oedema), Uraemia (pericarditis, encephalopathy).
General supportive: Strict I/O, daily weight ( < 1 kg/day gain), low Na/K/PO₄/protein diet, avoid nephrotoxins.
Post-AKI: Follow up renal function. Even mild AKI → risk of CKD transition. Educate on sick day rules.
Active Recall - AKI Management
References
[3] Senior notes: Block A - Glomerular and Tubulo-interstitial Diseases and Acute Kidney Injury.pdf (p30) [6] Senior notes: Ryan Ho Critical Care.pdf (p26) [7] Senior notes: Block A - Nephrotology Teaching Clinic RTD.pdf (p1, p7) [8] Senior notes: Block A - Abdominal distension_ ascites and cirrhosis.pdf (p22) [9] Senior notes: Block A - Chronic Kidney Disease and its Complications.pdf (p12) [10] Senior notes: Block A - Nephrology Interactive Tutorial.pdf (p4) [11] Senior notes: Maksim Medicine Notes.pdf (p218) [18] Senior notes: Block A - Nephrology Data Interpretation.pdf (p11) [19] Senior notes: Block A - Drugs and the Kidney.pdf (p1, p2, p8, p9) [23] Senior notes: MBBS Final MB (Medicine) (Felix PY Lai).pdf (p932) [29] Lecture slides: Handbook of Internal Medicine 2024.pdf (p306) [30] Lecture slides: Handbook of Internal Medicine 2024.pdf (p119) [31] Senior notes: Block A - Electrolyte and Acid-Base Disorders.pdf (p8, p30) [32] Senior notes: MBBS Final MB (Surgery) (Felix PY Lai).pdf (p863) [33] Senior notes: Ryan Ho Haemtology.pdf (p72)
Complications of Acute Kidney Injury
AKI complications arise from two sources: (1) the direct consequences of lost kidney function (fluid, electrolyte, acid-base, and waste product dysregulation), and (2) the long-term sequelae of renal injury even after apparent recovery. Understanding the pathophysiology behind each complication explains why it occurs and dictates its management.
AKI is associated with progressive kidney damage, decreased GFR, increased risk of developing complications, and mortality [3].
1. Acute (Immediate) Complications
These are the life-threatening complications that can kill the patient within hours to days. They correspond directly to the management priorities already discussed (AEIOU), but here we examine each in depth from a pathophysiological standpoint.
Why it happens: Potassium is the major intracellular cation (~98% of total body K⁺ is intracellular, [K⁺]ᵢ ~140 mmol/L vs. [K⁺]ₑ ~3.5–5.0 mmol/L). The kidney — specifically the distal nephron — is the primary route for K⁺ excretion. In AKI, the failing kidney cannot excrete the daily potassium load (~50–100 mmol/day from diet). Additionally:
- Metabolic acidosis (see below) drives H⁺ into cells, and K⁺ is displaced out of cells to maintain electroneutrality → transcellular shift worsening hyperkalaemia
- Tissue catabolism, rhabdomyolysis, tumour lysis → release of intracellular K⁺ into ECF
- Drugs that impair K⁺ excretion: ACEI/ARBs (↓ aldosterone), K⁺-sparing diuretics, calcineurin inhibitors
Clinical consequences:
Hyperkalaemia: symptoms (arrhythmia, weakness) usually only when K > 6 [6].
- Cardiac — the most dangerous effect. Hyperkalaemia reduces the resting membrane potential (makes it less negative) → altered conduction and repolarisation. ECG progression:
- K 6–7 mmol/L: tall, peaked T waves
- K 7–8 mmol/L: flattened P waves, prolonged PR
- K 8–10 mmol/L: widened QRS, aberrant complexes
- K > 10 mmol/L: sine wave → ventricular fibrillation → cardiac arrest
- Neuromuscular — muscle weakness (ascending, can mimic GBS), paraesthesiae, flaccid paralysis
- Metabolic — can worsen metabolic acidosis (hyperkalaemia impairs renal ammoniagenesis)
Management (covered in prior section): IV calcium gluconate → NaHCO₃ → insulin/dextrose → dialysis. Non-urgent: cation-exchange resins, loop diuretics, low K⁺ diet [6][31].
Clinical Pearl — Hyperkalaemia as the #1 Killer in AKI
Hyperkalaemia is the most immediately life-threatening complication of AKI. A patient can go from a normal rhythm to VF in minutes. Always check an ECG and K⁺ simultaneously in any patient with AKI. If peaked T waves are present, treat before the lab result is back.
Why it happens: The kidney normally maintains acid-base balance through two mechanisms:
- Reabsorbing filtered bicarbonate (~4,300 mmol/day is filtered; virtually all is normally reabsorbed in the PCT)
- Regenerating new bicarbonate by excreting H⁺ (as titratable acid and ammonium, NH₄⁺, in the distal nephron)
In AKI, both mechanisms fail → net accumulation of H⁺ → metabolic acidosis. Additionally, reduced renal clearance of organic acids (lactate, sulphate, phosphate, urate) contributes to a high anion gap metabolic acidosis (HAGMA).
Clinical consequences:
- Kussmaul's breathing — deep, laboured respirations as respiratory compensation (hyperventilation to blow off CO₂ and partially compensate for the acidosis) [6]
- Negative inotropic effect on the heart → reduced cardiac contractility
- Shifts K⁺ out of cells → worsens hyperkalaemia (for every 0.1 unit fall in pH, K⁺ rises by ~0.3–0.6 mmol/L)
- Resistance to catecholamines → hypotension harder to treat
- Protein catabolism → worsens uraemia
Management: Treat the underlying cause. NaHCO₃ infusion if pH < 7.2 or HCO₃⁻ < 10 mmol/L. Dialysis if refractory (pH < 7.1 despite NaHCO₃) [6].
Why it happens: The kidney normally excretes ~1.5–2 L of urine per day. In oliguric or anuric AKI, ongoing IV fluid administration and oral intake exceed output → positive fluid balance → extracellular fluid expansion. The excess fluid distributes into the interstitial space (peripheral oedema) and, critically, the lungs (pulmonary oedema).
Clinical consequences:
Fluid overload: peripheral oedema, hypertension, pulmonary oedema [6].
- Peripheral oedema — gravitational distribution (ankles when upright, sacrum when supine)
- Hypertension — volume-dependent hypertension from Na⁺ and water retention; also RAAS activation
- Pulmonary oedema — the most dangerous manifestation. Presents with acute dyspnoea, orthopnoea, pink frothy sputum, bilateral crepitations, hypoxaemia. CXR shows bilateral alveolar shadowing ("bat-wing" pattern), Kerley B lines, pleural effusions
- Pleural effusions — transudative effusions from fluid overload
Management: IV loop diuretics (furosemide up to 80 mg IV bolus or 10 mg/h infusion). Add metolazone 5–10 mg daily PO if refractory [29]. Fluid restriction. Sit upright, O₂. Dialysis/ultrafiltration if refractory to diuretics [6].
Why it happens: "Uraemia" literally means "urine in the blood" (Greek: "ouron" = urine, "haima" = blood). The kidney normally clears nitrogenous waste products: urea, creatinine, and a host of poorly characterised "uraemic toxins" (indoxyl sulphate, p-cresyl sulphate, asymmetric dimethylarginine, β₂-microglobulin, etc.). In AKI, these toxins accumulate to pathological levels.
Uraemic complications are indications for emergency dialysis:
| Complication | Pathophysiology | Clinical Features |
|---|---|---|
| Uraemic pericarditis | Direct irritation of pericardial serosa by uraemic toxins → haemorrhagic, fibrinous pericarditis | Pericardial friction rub, pleuritic chest pain, ECG changes (diffuse ST elevation, PR depression). Risk of haemorrhagic pericardial effusion → cardiac tamponade (uraemia causes platelet dysfunction → bleeding into pericardial space). This is an indication for emergency dialysis [6] |
| Uraemic encephalopathy | Uraemic toxins cross the BBB → neuronal dysfunction | Altered mental status, confusion, asterixis (flapping tremor), myoclonus, seizures, coma. Reversible with dialysis [6] |
| Uraemic neuropathy | Direct toxic effect on peripheral nerves | Distal sensorimotor neuropathy, restless legs. More common in CKD but can occur in severe AKI |
| Uraemic bleeding (platelet dysfunction) | Uraemic toxins (guanidinosuccinic acid, phenolic acids) inhibit platelet aggregation and adhesion. Also ↓ vWF function and ↑ NO production by platelets | Prolonged bleeding time with normal platelet count and normal coagulation studies. GI bleeding, epistaxis, bruising. Managed with DDAVP (desmopressin) — transiently increases vWF release, or dialysis |
| Uraemic gastropathy | Mucosal irritation by uraemic toxins | Nausea, vomiting, anorexia, hiccups. GI mucosal erosions → upper GI bleeding |
| Uraemic pruritus | Accumulation of uraemic toxins + calcium-phosphate deposition in skin + immune dysregulation + secondary hyperparathyroidism | Intense generalised itching, scratch marks (excoriations). Often refractory to antihistamines; responds to dialysis |
Signs of uraemia on examination: confusion, asterixis, scratch marks, tachypnoea, pericardial rub [34].
Uraemic Pericarditis — An Emergency
Uraemic pericarditis is a life-threatening complication and an absolute indication for urgent dialysis. The pericarditis is haemorrhagic (uraemic platelet dysfunction), so there is a high risk of pericardial tamponade. Anticoagulation during dialysis must be avoided (use citrate-based anticoagulation or dialysis without anticoagulation) to prevent worsening haemorrhagic effusion.
Why it happens: In AKI with oliguria, ongoing water intake (oral or IV) exceeds excretory capacity → dilutional hyponatraemia. Also, uraemia can cause "sick cell syndrome" (impaired Na⁺/K⁺-ATPase → Na⁺ enters cells, K⁺ leaks out).
Clinical consequences:
- Asymptomatic if mild (Na > 125 mmol/L)
- Nausea, headache, confusion at Na 120–125
- Seizures, coma, cerebral oedema, brainstem herniation at Na < 115–120
Too rapid correction of chronic hyponatraemia may result in central pontine myelinolysis → patients become tetraplegic [35]. The rate of correction should be slow: < 0.5 mmol/L/h, or < 12 mmol/L/day [35].
Why it happens:
- Hyperphosphataemia: The kidney normally excretes phosphate. In AKI, phosphate accumulates (especially marked in rhabdomyolysis and tumour lysis syndrome where intracellular phosphate is massively released)
- Hypocalcaemia: High phosphate → calcium-phosphate precipitation in tissues (metastatic calcification) → ↓ ionised calcium. Additionally, injured kidneys cannot convert 25-hydroxyvitamin D to 1,25-dihydroxyvitamin D (calcitriol) → ↓ intestinal calcium absorption
Clinical consequences:
- Tetany, perioral tingling, muscle cramps, Chvostek's sign, Trousseau's sign (from hypocalcaemia)
- QT prolongation → risk of torsades de pointes
- Nephrocalcinosis (calcium-phosphate deposition in renal tubules → can worsen AKI)
Why it happens: The kidney excretes ~70% of daily uric acid. In AKI, uric acid accumulates. Massively elevated in tumour lysis syndrome (rapid nucleic acid catabolism). Uric acid crystals can precipitate in the renal tubules → uric acid nephropathy → can worsen or even cause AKI in a vicious cycle.
Why it happens: AKI itself is an immunocompromised state. Uraemic toxins impair neutrophil chemotaxis, phagocytosis, and lymphocyte function. Invasive procedures (urinary catheters, central venous catheters for dialysis, nasogastric tubes) provide portals of entry for pathogens. Critically ill AKI patients in ICU are at high risk for nosocomial infections.
Common infections: Catheter-related UTI, catheter-related bloodstream infection (CRBSI), hospital-acquired pneumonia, Clostridioides difficile colitis.
Why it happens in the AKI context: AKI can be both a cause and consequence of DIC:
- Sepsis-driven AKI → sepsis-induced DIC → microthrombi in renal vasculature → ATN → worsening AKI (vicious cycle)
- ABO-incompatible transfusion → complement activation → free haemoglobin release → platelet activation + coagulation system activation → DIC → thrombus formed in renal vasculature → AKI [36]
2. Subacute Complications (Days to Weeks)
Why it happens: After relief of bilateral urinary obstruction (post-renal AKI), accumulated urea and sodium in the medullary interstitium act as osmotic diuretics. Additionally, the tubules are transiently unable to concentrate urine (acquired nephrogenic diabetes insipidus from chronic medullary washout). This produces massive polyuria (up to 5–10 L/day).
Clinical consequences:
- Hypovolaemia, hypotension, dehydration if losses are not replaced
- Hyponatraemia, hypokalaemia from excessive electrolyte losses
Management: Close monitoring of UO and electrolytes. Replace ~50–75% of hourly urine output with IV NS or half-NS to prevent haemodynamic collapse while allowing the physiological diuresis to resolve retained solutes. Full replacement of every mL risks perpetuating the diuresis.
Diuretic phase of ATN: gradual normalisation of GFR, markedly increased urine output — up to 3 L/day. Urine output gradually returns to normal [7].
Why it happens: As tubular cells regenerate, GFR begins to improve, but the regenerating tubular epithelium is initially "leaky" — unable to reabsorb sodium and water normally. Accumulated urea also acts as an osmotic diuretic.
Clinical significance:
- The diuretic phase looks encouraging (creatinine starts to fall), but patients can become dehydrated if fluid intake does not match the increased output
- Electrolyte losses (Na⁺, K⁺, Mg²⁺, PO₄³⁻) must be monitored and replaced
- Does NOT mean the kidney has fully recovered — the nephrons are regenerating but not yet fully functional
Why it happens: AKI triggers a hypercatabolic state — metabolic acidosis promotes protein catabolism, uraemic toxins suppress appetite, and the underlying illness (sepsis, surgery, trauma) increases metabolic demands. Dietary restriction (low protein, low K⁺, low PO₄³⁻) further limits caloric and nitrogen intake.
Clinical consequences: Muscle wasting, poor wound healing, immunosuppression, delayed recovery. Mortality is significantly higher in malnourished AKI patients.
Management: Early nutritional support. Protein intake should be 0.8–1.0 g/kg/day in non-dialysis AKI, increased to 1.0–1.5 g/kg/day if on CRRT (amino acid losses across the filter). Adequate caloric intake (25–30 kcal/kg/day).
3. Long-Term Complications
Even mild, reversible AKI can have important clinical consequences, e.g., CKD transition [3][25].
Why it happens: Even when creatinine returns to "baseline," subclinical injury may persist:
- Maladaptive repair — some tubular cells undergo G2/M cell cycle arrest → produce profibrotic cytokines (TGF-β, CTGF) → tubulointerstitial fibrosis
- Nephron loss — dead nephrons are replaced by scar tissue, not new nephrons. The remaining nephrons hypertrophy to compensate (compensatory hyperfiltration), but this eventually leads to glomerulosclerosis (like CKD from any cause)
- Microvascular rarefaction — peritubular capillary loss after AKI → chronic tubular ischaemia → further fibrosis
Risk factors for AKI-to-CKD transition:
- Severity and duration of AKI (Stage 3, prolonged oliguria, need for dialysis → higher CKD risk)
- Pre-existing CKD (reduced nephron reserve → less capacity for compensatory recovery)
- Recurrent AKI episodes
- Older age, diabetes, hypertension
Clinical implications:
- AKI is associated with increased risk of developing complications and mortality [3]
- Patients who survive AKI have increased long-term risk of CKD, ESRD, cardiovascular events, and death compared to matched controls even if creatinine returns to baseline
- All AKI survivors should have renal function monitored at 3 months and annually thereafter
High Yield — AKI to CKD Transition
Even mild, reversible AKI has important long-term clinical consequences such as CKD transition [3][25]. This is one of the key reasons the terminology changed from "acute renal failure" to "acute kidney injury" — to capture the full spectrum of injury, including cases that appear to "fully recover" but carry significant long-term risk. Always follow up AKI patients.
If AKI does not fully recover and the patient develops CKD, all the complications of CKD apply:
| Complication | Pathophysiology |
|---|---|
| Metabolic acidosis | Impaired H⁺ excretion and HCO₃⁻ regeneration (same as AKI but chronic) |
| Hypertension, LVH | Na⁺/water retention, RAAS activation → volume-dependent HTN → LVH |
| Congestive cardiac failure → HFrEF | Chronic volume overload + HTN + uraemic cardiomyopathy |
| Normochromic normocytic anaemia | Lack of erythropoietin production by failing kidneys [9]. Also iron deficiency (from uraemic gastropathy/GI bleeding), chronic inflammation |
| CKD-MBD (Mineral and Bone Disorder) | CKD → poor activation of Vit D → hypocalcaemia and hyperphosphataemia → body releases more PTH → secondary hyperparathyroidism [9]. Results in renal osteodystrophy (osteitis fibrosa cystica, osteomalacia, adynamic bone disease), vascular calcification [9], and fractures |
| Fluid retention | Impaired Na⁺ and water excretion |
| Uraemic pruritus | Retained uraemic toxins, calcium-phosphate skin deposition |
If AKI is severe enough to require dialysis, the dialysis itself carries complications:
General complications of RRT [34]:
| Complication | Mechanism |
|---|---|
| Malnutrition | Amino acid and protein losses across the dialysis membrane; anorexia from uraemia |
| Accelerated atherosclerosis | Chronic inflammation, dyslipidaemia, calcium-phosphate deposition in vessel walls |
| Dialysis-related amyloidosis | Accumulation of β₂-microglobulin (poorly cleared by conventional dialysis) → deposition in joints and tendons → carpal tunnel syndrome, bone cysts, destructive arthropathy |
| Acquired cystic disease ± malignant transformation | Long-term dialysis → cystic changes in native kidneys → ↑ risk of renal cell carcinoma |
| Dialysis-related dementia | Cerebral aluminium toxicity — historical complication from aluminium-containing phosphate binders and contaminated dialysate water. Rare with modern treatment |
Haemodialysis-specific:
- Hypotension during dialysis — rapid fluid removal (ultrafiltration) → haemodynamic instability, especially in elderly or cardiac patients
- Catheter-related complications — infection (CRBSI), thrombosis, central vein stenosis
- AV fistula/graft complications (if present for chronic access) — thrombosis, stenosis, steal syndrome, aneurysm, infection
- Dialysis disequilibrium syndrome — rapid removal of urea during dialysis creates an osmotic gradient between blood and brain → cerebral oedema → headache, confusion, seizures, coma. More common in first sessions. Prevented by slower, shorter initial dialysis runs.
Peritoneal dialysis-specific:
- PD-related peritonitis — infection of the peritoneal space, typically from skin commensals (S. epidermidis, S. aureus). Presents with cloudy PD effluent, abdominal pain, fever. Treated with intraperitoneal antibiotics.
- Catheter exit site infection
- Protein losses across the peritoneal membrane → hypoalbuminaemia
- Mechanical complications — hernia, hydrothorax (peritoneal fluid leaks through diaphragmatic defects)
AKI is an independent risk factor for cardiovascular events — not just through the CKD transition but through direct mechanisms:
- Systemic inflammation during AKI → endothelial dysfunction, accelerated atherosclerosis
- Electrolyte disturbances (hyperkalaemia) → arrhythmias, sudden cardiac death
- Volume overload → acute heart failure
- Uraemic toxins → direct myocardial toxicity, pericarditis
This is why even "mild" AKI (Stage 1) is independently associated with increased long-term mortality, cardiovascular events, and hospital readmission.
AKI frequently occurs as part of multi-organ dysfunction syndrome (MODS) in critical illness:
Many patients in the ICU require a nephrology consult, because they have critical illness involving the kidney [3].
| Primary Disease | How It Causes AKI |
|---|---|
| Sepsis | Vasodilatory shock → renal hypoperfusion + direct tubular injury from inflammatory mediators → ATN |
| Liver failure | Splanchnic vasodilation → ↓ effective circulating volume → renal vasoconstriction → HRS. AKI complicates 30–70% of acute liver injury |
| Heart failure | Cardiorenal syndrome — ↓ cardiac output → ↓ renal perfusion → pre-renal AKI. Also, venous congestion → ↑ renal venous pressure → ↓ net filtration pressure |
| Multiple myeloma | Cast nephropathy (myeloma kidney) — at least 50% of patients with newly diagnosed myeloma will have renal involvement. Also hypercalcaemia, dehydration, amyloidosis [27] |
| ABO-incompatible transfusion | Complement activation → intravascular haemolysis → free haemoglobin → platelet activation, NO binding, smooth muscle dystonia in renal vasculature → AKI. Also DIC → microthrombi in renal vasculature → AKI [36] |
| Tumour lysis syndrome | Uric acid + calcium-phosphate crystal deposition in tubules → obstruction and direct toxicity → ATN |
| Rhabdomyolysis | Myoglobin precipitates in tubules → direct toxicity + obstruction → pigment nephropathy → ATN |
| Time Frame | Complication | Key Pathophysiology | Key Clinical Feature |
|---|---|---|---|
| Minutes to hours | Hyperkalaemia | ↓ Renal K⁺ excretion + transcellular shift | ECG: peaked T → widened QRS → VF |
| Hours to days | Metabolic acidosis | ↓ H⁺ excretion + ↓ HCO₃⁻ regeneration | Kussmaul breathing; worsens hyperK |
| Hours to days | Fluid overload / pulmonary oedema | ↓ Na⁺/H₂O excretion | Dyspnoea, crackles, ↑ JVP, HTN |
| Days | Uraemic pericarditis | Direct toxin irritation of pericardium | Friction rub; risk of tamponade → emergency dialysis |
| Days | Uraemic encephalopathy | Toxins cross BBB | Confusion, asterixis, seizures |
| Days | Uraemic bleeding | Platelet dysfunction | Prolonged bleeding time, GI bleed |
| Days to weeks | Infections/sepsis | Uraemic immunosuppression + invasive lines | Catheter-related infections, pneumonia |
| Days to weeks | Post-obstructive / ATN diuretic phase | Osmotic diuresis + tubular leak | Massive polyuria → dehydration risk |
| Weeks to months | AKI → CKD transition | Maladaptive repair, fibrosis, nephron loss | Persistently elevated Cr, proteinuria |
| Months to years | CKD complications | Permanent nephron loss | Anaemia, CKD-MBD, HTN, CVD |
| If on dialysis | Dialysis complications | RRT-specific | Infections, disequilibrium, amyloidosis |
High Yield Summary
Acute complications (life-threatening):
- Hyperkalaemia — #1 immediate killer. ECG changes progress from peaked T → VF. Treat with IV Ca (cardioprotective, does NOT lower K), insulin/dextrose, NaHCO₃, dialysis.
- Metabolic acidosis — ↓ H⁺ excretion. HAGMA from uraemia. Causes Kussmaul breathing, worsens hyperK. Mx: NaHCO₃, dialysis.
- Fluid overload / pulmonary oedema — ↓ Na/H₂O excretion. Mx: loop diuretics ± metolazone, dialysis.
- Uraemic complications — pericarditis (emergency dialysis indication), encephalopathy (asterixis, seizures), bleeding (platelet dysfunction → DDAVP), pruritus, gastropathy.
Subacute complications:
- Post-obstructive / ATN diuretic phase → polyuria → dehydration + electrolyte losses.
- Malnutrition from catabolism + dietary restriction.
- Infections from immunosuppression + invasive lines.
Long-term complications:
- AKI → CKD transition — even mild AKI. Maladaptive repair → fibrosis → permanent nephron loss. Follow up all AKI survivors.
- CKD complications: anaemia (↓ EPO), CKD-MBD (secondary hyperPTH, vascular calcification), HTN/LVH, HF.
- Increased cardiovascular morbidity and mortality.
- Dialysis-related complications if RRT needed.
Active Recall - Complications of AKI
References
[3] Senior notes: Block A - Glomerular and Tubulo-interstitial Diseases and Acute Kidney Injury.pdf (p30, p33) [6] Senior notes: Ryan Ho Critical Care.pdf (p25-26) [7] Senior notes: Block A - Nephrotology Teaching Clinic RTD.pdf (p7) [9] Senior notes: Block A - Chronic Kidney Disease and its Complications.pdf (p12, p13, p23) [25] Lecture slides: GC 057. Glomerular and Tubulo-interstitial Diseases and Acute Kidney Injury.pdf (p60) [27] Senior notes: Block A - An old man with bone pain and anaemia_ multiple myeloma; monoclonal gammopathy.pdf (p19) [29] Lecture slides: Handbook of Internal Medicine 2024.pdf (p306) [31] Senior notes: Block A - Electrolyte and Acid-Base Disorders.pdf (p22, p30) [34] Senior notes: Maksim Medicine Notes.pdf (p222) [35] Senior notes: Block A - Electrolyte and Acid-Base Disorders.pdf (p22) [36] Senior notes: Block A - Fever after a blood transfusion_ transfusion and related problems.pdf (p10)
High Yield Summary
Definition: AKI = abrupt ↓ kidney function. KDIGO 2012: ↑ Cr ≥ 26.5 μmol/L in 48h, OR ↑ Cr ≥ 1.5× baseline in 7d, OR UO < 0.5 mL/kg/h for 6h.
Staging: 3 stages (KDIGO) based on Cr rise and UO — Stage 3 includes Cr ≥ 3× or ≥ 353.6 μmol/L or RRT initiation.
Aetiology: Pre-renal ( > 50%) — hypovolaemia, ↓ CO, vasodilation; Intrinsic renal ( < 50%) — ATN (ischaemic/toxic), AIN, GN, vascular; Post-renal ( < 10%) — obstruction (must be bilateral).
Risk factors: Age > 50, pre-existing CKD, DM, HF, liver disease, sepsis, post-op, nephrotoxic drugs.
Clinical features: Oliguria, oedema, HTN, electrolyte disturbance (↑K, acidosis), uraemia (N/V, confusion, pericarditis, asterixis).
Key distinctions: Pre-renal (FENa < 1%, concentrated urine, responds to fluids) vs. ATN (FENa > 2%, muddy brown casts, does not respond to fluids).
AKI → CKD transition: Even mild AKI can lead to permanent nephron loss and CKD.
Drug-related AKI is common and preventable — always review the drug chart in any patient with AKI.
High Yield Summary
Approach: Always classify AKI into pre-renal ( > 50%), intrinsic renal ( < 50%), or post-renal ( < 10%).
Pre-renal: Most common overall. Hypovolaemia, ↓ CO, sepsis, drugs (NSAID, ACEI/ARB). FENa < 1%. Reversible with fluids.
Intrinsic — ATN: Most common intrinsic cause. Ischaemic (prolonged pre-renal) or nephrotoxic (drugs, pigments, light chains). Muddy brown casts. FENa > 2%.
Intrinsic — AIN: Drug-induced (antibiotics, PPIs, NSAIDs, PD-1 inhibitors). Classic triad: fever, rash, eosinophilia (but < 30%). WBC casts. Consider TB drugs in Hong Kong.
Intrinsic — GN/RPGN: Nephritic syndrome (haematuria, HTN, oedema). RBC casts. Anti-GBM, ANCA vasculitis, lupus nephritis. Medical emergency if RPGN.
Post-renal: < 10%. Must be bilateral obstruction. Check catheter. US shows hydronephrosis. Rapidly reversible.
Always review drugs. Always check kidney size on US. Always consider myeloma in elderly with unexplained AKI + anaemia.
High Yield Summary
Diagnostic criteria: KDIGO 2012 — any ONE of: ↑ Cr ≥ 26.5 μmol/L in 48h, ↑ Cr ≥ 1.5× in 7d, or UO < 0.5 mL/kg/h for 6h. Three stages based on severity.
Cr limitations: Insensitive early (GFR already ↓50%); unreliable on dialysis; affected by muscle mass. NGAL and cystatin C are emerging biomarkers.
Algorithm: ABC → Exclude post-renal (catheter, US) → Assess volume (pre-renal?) → Fluid challenge → If no improvement: investigate intrinsic → Review drugs → Manage complications → Consider dialysis (AEIOU).
Key discriminating tests: FENa (< 1% pre-renal vs. > 2% ATN); urine sediment (muddy brown = ATN, RBC casts = GN, WBC casts = AIN); kidney size on US (normal/large = AKI, small = CKD).
Autoimmune screen when active sediment or systemic features: ANA, ANCA, anti-GBM, C3/C4, HBV/HCV. Protein electrophoresis if myeloma suspected.
Renal biopsy for: unexplained AKI with normal-sized kidneys, suspected RPGN, AIN not improving, myeloma kidney. Contraindicated: small kidneys, large cysts, solitary kidney.
Always do ECG (hyperkalaemia) and CXR (fluid overload) in every AKI patient.
High Yield Summary
Management framework: Resuscitate (ABC, fluids) → Reverse cause (post-renal → pre-renal → drug → intrinsic) → Manage complications (AEIOU) → Dialysis if refractory.
Pre-renal: NS 500–1000 mL over 1–2h. Low-dose dopamine NOT recommended.
Post-renal: Relieve obstruction. Watch for post-obstructive diuresis.
Drug-related: Stop all nephrotoxins (NSAIDs, aminoglycosides, ACEI/ARB, metformin, contrast).
ATN: Supportive only — hydration + stop offending agent. No specific drug therapy.
AIN: Stop drug. Steroids only if severe/refractory (especially checkpoint inhibitor AKI — responsive to steroids).
HRS: IV albumin (1 g/kg/day × 2 days) + IV terlipressin. RRT as bridge to liver transplant.
Rhabdomyolysis: Aggressive IV NS + urine alkalinisation + allopurinol + dialysis if refractory.
Hyperkalaemia: IV Ca (cardioprotective, does NOT lower K) → NaHCO₃ → insulin/dextrose → dialysis. Non-urgent: resins (Lokelma/Patiromer), loop diuretics.
Dialysis (AEIOU): Acidosis (pH < 7.1, HCO₃ < 10), Electrolytes (K > 6–6.5 refractory), Intoxication, Overload (refractory pulmonary oedema), Uraemia (pericarditis, encephalopathy).
General supportive: Strict I/O, daily weight ( < 1 kg/day gain), low Na/K/PO₄/protein diet, avoid nephrotoxins.
Post-AKI: Follow up renal function. Even mild AKI → risk of CKD transition. Educate on sick day rules.
High Yield Summary
Acute complications (life-threatening):
- Hyperkalaemia — #1 immediate killer. ECG changes progress from peaked T → VF. Treat with IV Ca (cardioprotective, does NOT lower K), insulin/dextrose, NaHCO₃, dialysis.
- Metabolic acidosis — ↓ H⁺ excretion. HAGMA from uraemia. Causes Kussmaul breathing, worsens hyperK. Mx: NaHCO₃, dialysis.
- Fluid overload / pulmonary oedema — ↓ Na/H₂O excretion. Mx: loop diuretics ± metolazone, dialysis.
- Uraemic complications — pericarditis (emergency dialysis indication), encephalopathy (asterixis, seizures), bleeding (platelet dysfunction → DDAVP), pruritus, gastropathy.
Subacute complications:
- Post-obstructive / ATN diuretic phase → polyuria → dehydration + electrolyte losses.
- Malnutrition from catabolism + dietary restriction.
- Infections from immunosuppression + invasive lines.
Long-term complications:
- AKI → CKD transition — even mild AKI. Maladaptive repair → fibrosis → permanent nephron loss. Follow up all AKI survivors.
- CKD complications: anaemia (↓ EPO), CKD-MBD (secondary hyperPTH, vascular calcification), HTN/LVH, HF.
- Increased cardiovascular morbidity and mortality.
- Dialysis-related complications if RRT needed.
Chronic Kidney Disease
Chronic kidney disease is a progressive condition characterized by a sustained reduction in glomerular filtration rate (GFR < 60 mL/min/1.73 m²) or evidence of kidney damage persisting for three or more months, leading to irreversible loss of renal function.
Systemic Lupus Erythematosus
Systemic lupus erythematosus is a chronic multisystem autoimmune disorder characterized by the production of autoantibodies (notably anti-dsDNA and anti-Smith) causing widespread inflammation and tissue damage affecting the skin, joints, kidneys, blood cells, and other organs.