Acute Kidney Injury

The session has the following topics:

• Acute Kidney Injury–Experimental Models
• Clinical Studies including Toxic Nephropathy
• Biomarkers for Acute Kidney Injury
• Acute Renal Failure–Clinical
• Acute Kidney Injury-Onco-Nephrology (Diseases)
• Acute Kidney Injury–Onco-Nephrology (Drugs)
• Acute Kidney Injury–Pregnancy (Pre-Eclampsia, TMA, HELLP, Other Causes)
• Acute Kidney Injury–Update on CRRT, SLED, etc.
• Extracorporeal Therapies - Intoxications, Overdoses, Liver Failure, etc.

When your kidneys stop working suddenly, over a very short period of time (usually two days or less), it is called acute kidney injury (AKI). AKI is sometimes called acute kidney failure or acute renal failure. It is very serious and requires immediate treatment.

Unlike kidney failure that results from kidney damage that gets worse slowly, AKI is often reversible if it is found and treated quickly. If you were healthy before your kidneys suddenly failed and you were treated for AKI right away, your kidneys may work normally or almost normally after your AKI is treated. Some people have lasting kidney damage after AKI. This is called chronic kidney disease, and it could lead to kidney failure if steps are not taken to prevent the kidney damage from getting worse.

Symptoms

Signs and symptoms of acute kidney failure may include:

• Decreased urine output, although occasionally urine output remains normal
• Fluid retention, causing swelling in your legs, ankles or feet
• Shortness of breath
• Fatigue
• Confusion
• Nausea
• Weakness
• Irregular heartbeat
• Chest pain or pressure
• Seizures or coma in severe cases

Sometimes acute kidney failure causes no signs or symptoms and is detected through lab tests done for another reason.

Causes

Acute kidney failure can occur when:

• You have a condition that slows blood flow to your kidneys
• You experience direct damage to your kidneys
• Your kidneys' urine drainage tubes (ureters) become blocked and wastes can't leave your body through your urine

Impaired blood flow to the kidneys

Diseases and conditions that may slow blood flow to the kidneys and lead to kidney injury include:

• Blood or fluid loss
• Blood pressure medications
• Heart attack
• Heart disease
• Infection
• Liver failure
• Use of aspirin, ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve, others) or related drugs
• Severe allergic reaction (anaphylaxis)
• Severe burns
• Severe dehydration

Damage to the kidneys

These diseases, conditions and agents may damage the kidneys and lead to acute kidney failure:

• Blood clots in the veins and arteries in and around the kidneys
• Cholesterol deposits that block blood flow in the kidneys
• Glomerulonephritis (gloe-mer-u-loe-nuh-FRY-tis), inflammation of the tiny filters in the kidneys (glomeruli)
• Hemolytic uremic syndrome, a condition that results from premature destruction of red blood cells
• Infection
• Lupus, an immune system disorder causing glomerulonephritis
• Medications, such as certain chemotherapy drugs, antibiotics and dyes used during imaging tests
• Scleroderma, a group of rare diseases affecting the skin and connective tissues
• Thrombotic thrombocytopenic purpura, a rare blood disorder
• Toxins, such as alcohol, heavy metals and cocaine
• Muscle tissue breakdown (rhabdomyolysis) that leads to kidney damage caused by toxins from muscle tissue destruction
• Breakdown of tumor cells (tumor lysis syndrome), which leads to the release of toxins that can cause kidney injury

Urine blockage in the kidneys

Diseases and conditions that block the passage of urine out of the body (urinary obstructions) and can lead to acute kidney injury include:

• Bladder cancer
• Blood clots in the urinary tract
• Cervical cancer
• Colon cancer
• Enlarged prostate
• Kidney stones
• Nerve damage involving the nerves that control the bladder
• Prostate cancer

Risk factors

Acute kidney failure almost always occurs in connection with another medical condition or event. Conditions that can increase your risk of acute kidney failure include:

• Being hospitalized, especially for a serious condition that requires intensive care
• Advanced age
• Blockages in the blood vessels in your arms or legs (peripheral artery disease)
• Diabetes
• High blood pressure
• Heart failure
• Kidney diseases
• Liver diseases
• Certain cancers and their treatments

Complications

Potential complications of acute kidney failure include:

• Fluid buildup. Acute kidney failure may lead to a buildup of fluid in your lungs, which can cause shortness of breath.
• Chest pain. If the lining that covers your heart (pericardium) becomes inflamed, you may experience chest pain.
• Muscle weakness. When your body's fluids and electrolytes — your body's blood chemistry — are out of balance, muscle weakness can result.
• Permanent kidney damage. Occasionally, acute kidney failure causes permanent loss of kidney function, or end-stage renal disease. People with end-stage renal disease require either permanent dialysis — a mechanical filtration process used to remove toxins and wastes from the body — or a kidney transplant to survive.
• Death. Acute kidney failure can lead to loss of kidney function and, ultimately, death.

Prevention

Acute kidney failure is often difficult to predict or prevent. But you may reduce your risk by taking care of your kidneys. Try to:

• Pay attention to labels when taking over-the-counter (OTC) pain medications.Follow the instructions for OTC pain medications, such as aspirin, acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve, others). Taking too much of these medications may increase your risk of kidney injury. This is especially true if you have pre-existing kidney disease, diabetes or high blood pressure.
• Work with your doctor to manage kidney and other chronic conditions. If you have kidney disease or another condition that increases your risk of acute kidney failure, such as diabetes or high blood pressure, stay on track with treatment goals and follow your doctor's recommendations to manage your condition.
• Make a healthy lifestyle a priority. Be active; eat a sensible, balanced diet; and drink alcohol only in moderation — if at all.

List of Nephrology Societies

1. AAMI Standards for Haemodialysis
2. African Association of Nephrology (AFRAN)
3. Albanian Society of Nephrology
4. American Association of Kidney Patients
5. American Nephrology Nurses Association (ANNA)
6. American Renal Associates
7. American Society of Nephrology
8. American Society of Nephrology
9. American Society of Pediatric Nephrology
10. American Society of Transplant Surgeons
11. American Society of Transplantation
12. Arab Society of Nephrology & Renal Transplantation
13. Argentina Society of Nephrology
14. Asian Pacific Society of Nephrology
15. Asian Pediatric Nephrology Association
16. Association for nephrology, dialysis and transplantation of Bosnia and Herzegovina
17. Association of Cardionephrology of Serbia
18. Association of Nephrology and Hypertension of El Salvador
19. Australian and New Zealand Society of Nephrology
20. Austrian Society of Nephrology
21. Bangladesh Renal Association
22. Belgian Transplantation Society
23. Belgian-Dutch Speaking Society of Nephrology
24. BKPA - British Kidney Patient Association
25. Bolivian Society of Nephrology
26. Brazilian Society of Nephrology
27. British Association of Pediatric Nephrology
28. British Renal Society
29. British Transplantation Society
30. Bulgarian Society of Nephrology
31. Canadian Association of Nephrology Nurses and Technologists
32. Canadian Society of Nephrology
33. Canadian Society of Transplantation
34. Cardio Renal Society of America
35. Cardio Renal Society of America
36. Chile Society of Nephrology
37. Chinese Society of Nephrology
38. Colombian Society of Nephrology
39. Costarican Society of Nephrology
40. Croatian Society of Nephrology, Dialysis & Transplantation
41. Cuban Society of Nephrology
42. Danish Society of Nephrology
43. Dialysis, Nephrology and Kidney Transplantation Union of Georgia
44. Dutch Federation of Nephrology
45. Ecuadorian Society of Nephrology
46. Egyptian Society of Nephrology
47. Emirates Medical Association Nephrology Society
48. ERA-EDTA (The European Renal Association – European Dialysis and Transplant Association)
49. Estonian Society of Nephrology
50. European Society for Paediatric Nephrology
51. Forum of end stage renal disease networks
52. French Society of Nephrology
53. German Society of Nephrology
54. Guatemalan Society of Nephrology
55. Hellenic Society of Nephrology
56. Hong Kong Society of Nephrology
57. Hungarian Society of Nephrology
58. Hypertension, dialysis and clinical nephrology (HDCN)
59. India Renal Foundation
60. Indian Society of Nephrology
61. Indian Society of Pediatric Nephrology
62. Indonesian Society of Nephrology
63. International Pediatric Nephrology Association (IPNA)
64. International Society For Apheresis (ISFA)
65. International Society for Hemodialysis
66. International Society for Peritoneal Dialysis (ISPD)
67. International Society of Nephrology (ISN)
68. International Society of Renal Nutrition and Metabolism
69. Iranian Society of Nephrology
70. Iraqi Society of Nephology
71. Iraqi Society of Nephrology
72. Irish Kidney Association
73. Irish Nephrology Society
74. Israel Society of Nephrology and Hypertension
75. Italian Society of nephrology
76. Japanese Society of Nephrology
77. Jivana Organ Donation Society's
78. Jordan Society of Nephrology and Renal Transplantation
79. Kenya Renal Association
80. Kidney Cancer Association
81. kidney society
82. Kidney Transplant/Dialysis Association
83. Korean Society of Nephrology
84. Kuwait Nephrology Association
85. Latin-American Society of Nephrology and Hypertension
86. Latvian Association of Nephrology
87. Lebanese Society of Nephrology & Hypertension
88. Lebanese Society of Nephrology and Hypertension
89. Macedonian Soc. of Nephrology, Dialysis, Transplantation and Artificial Organs
90. Malaysian Society of Nephrology
91. Mexican College of Nephrologists
92. Mexican Institute for Nephrologycal Research
93. Midwest Pediatric Nephrology Consortium
94. Moldavian Society of Nephrology
95. Mongolian Society of Nephrology and Urology
96. Montenegrin Association of Nephrologists
97. Moroccan Society of Nephrology
98. Myanmar NephroUro Society
99. National Association of Dialysis and Transplantation
100. National Renal Administrators Association
101. Nephrology Society of Tanzania
102. Nephrology Society of Thailand
103. New York Society of Nephrology
104. Nigerian Association of Nephrology
105. Norwegian Society of Nephrology
106. Ohio Renal Association
107. Pakistan Society of Nephrology and Urology
108. Panamanian Society of Nephrology
109. Paraguayan Society of Nephrology
110. Peritoneal Dialysis Society of India
111. Peruvian Society of Nephrology
112. Philippine Society of Nephrology
113. Polish Society of Nephrology
114. Portuguese Society of Nephrology
115. Puerto Rican Society of Nephrology and Hypertension
116. Renal and Transplant Associates of New England
117. Renal Association
118. Renal Association
119. Renal Nutrition Group
120. Renal Pathology Society
121. Renal Physicians Association (RPA)
122. Renal Society of Australasia
123. Romanian Society of Nephrology
124. Russian Dialysis Society
125. Saudi Society of Nephrology
126. Saudi Society of Nephroloty & Transplantation
127. Senegalese Society of Nephrology
128. Singapore Society of Nephrology
129. Slovenian Society of Nephrology
130. Society for Transplant Social Workers
131. Society of Nephrologists, Dialysis and Transplant Physicians of Kazakhstan
132. South African Renal Society
133. Spanish Society of Nephrology/Fundacion Senefro
134. Sri Lanka Society of Nephrology
135. Sudanese Society of Nephrology
136. Swedish Society of Nephrology
137. Swiss Society of Nephrology
138. Syrian Society of Nephrology & Transplantation
139. Taiwan Society of Nephrology
140. The European Dialysis and Transplant Nurses Association/European Renal Care Association (EDTNA/ERCA)
141. The Hong Kong Association of Renal Nurses (HKARN)
142. The National Kidney Foundation
143. The Swedish Nephrology Nurses' Association
144. The Transplantation Society
145. Tunisian Society of Nephrology
146. Turkish Society of Nephrology
147. UK Renal Registry
148. Ukranian Nephrology Association
149. Uruguayan Society of Nephrology
150. Venezuelan Society of Nephrology
151. Yemen Society for Nephrology and Transplantation
152. National Renal Administrators Association