Aaradhya Balaji Kidney Care – Kidney Specialist In Nagpur, Nephrologist, Kidney Transplant, Dialysis & Stone Specialist

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Kidney Injury Management

Kidney Injury Management
Kidney injury, or acute kidney injury (AKI), occurs when the kidneys suddenly lose their ability to filter waste and balance fluids and electrolytes. It can range from mild to severe and requires prompt diagnosis and management to prevent complications and long-term damage.

Types of Kidney Injury

  1. Prerenal AKI: Caused by factors outside the kidneys (e.g., dehydration, heart failure).
  2. Intrinsic AKI: Direct damage to the kidney tissue (e.g., due to toxins, infections, or autoimmune conditions).
  3. Postrenal AKI: Obstruction of urine flow, such as kidney stones or tumors.

Management Strategies

1. Early Diagnosis

  • Monitoring Kidney Function:
    Regular blood tests to assess kidney function (e.g., serum creatinine, blood urea nitrogen, and glomerular filtration rate (GFR)).
  • Urine Tests:
    Monitoring urine output, urine analysis for proteinuria, and blood in the urine.

2. Addressing Underlying Causes

  • Prerenal AKI:

    • Treat underlying conditions like dehydration, heart failure, or shock.
    • Restore blood volume through fluids and medications (e.g., IV fluids, vasopressors).

  • Intrinsic AKI:

    • Avoid nephrotoxic agents (e.g., nonsteroidal anti-inflammatory drugs (NSAIDs), certain antibiotics).
    • Treat underlying conditions such as infections (e.g., sepsis, pyelonephritis), autoimmune diseases, or acute glomerulonephritis.
    • Medications like corticosteroids or immunosuppressants for autoimmune causes.

  • Postrenal AKI:

    • Remove obstructions (e.g., kidney stones, tumors, strictures) via surgery, catheter placement, or drainage.

3. Fluid and Electrolyte Management

  • Hydration:
    Adequate fluid intake to avoid dehydration, but carefully managed to prevent fluid overload.
  • Electrolyte Balance:
    • Correct abnormalities like hyperkalemia (high potassium), hyponatremia (low sodium), or acidosis.
    • Dialysis may be required if electrolyte imbalances are severe.

4. Dialysis

Used when kidney function is critically impaired and conservative management isn’t sufficient.

  • Hemodialysis or Peritoneal Dialysis may be necessary to remove waste, fluid, and toxins.
  • Indications for dialysis: Severe fluid overload, high levels of toxins (e.g., uremia), electrolyte imbalances, or acidosis.
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