Diagnosis
You might have the following tests to diagnose acute kidney injury:
- Blood tests. A sample of your blood may show fast-rising levels of urea and creatinine. This helps show how your kidneys are working.
- Urine output measures. Measuring how much urine you pass in 24 hours may help find the cause of your kidney failure.
- Urine tests. A sample of your urine may show something that suggests a condition that might explain kidney failure. This is called urinalysis.
- Imaging tests. Imaging tests such as ultrasound and CT scans can show your kidneys.
- Removing a sample of kidney tissue for testing. Your healthcare professional may suggest removing a small sample of your kidney tissue for lab testing. This is called a biopsy. A needle put through your skin and into your kidney removes the sample.
Treatment
Treatment for acute kidney injury most often means a hospital stay. Most people with acute kidney injury are already in the hospital. How long you'll stay in the hospital depends on the reason for your acute kidney injury and how quickly your kidneys recover.
Treating the cause of your kidney injury
Treatment for acute kidney injury involves finding the illness or injury that damaged your kidneys. Your treatment depends on the cause. It might involve stopping a medicine that's damaging your kidneys.
Treating complications until your kidneys recover
Your healthcare team also works to prevent complications and give your kidneys time to heal. Treatments that help prevent complications include:
Treatments to balance fluids in your blood. If a lack of fluids in your blood is the cause of your acute kidney injury, you may need fluids through a vein, called intravenous (IV) fluids.
If acute kidney injury causes you to have too much fluid, this may lead to swelling in your arms and legs. Then you may need medicines called diuretics, which cause your body to get rid of extra fluids.
Medicines to control blood potassium. Your kidneys might not filter potassium from your blood well enough. Potassium regulates blood pressure and other body functions.
You might need medicines called potassium binders to keep potassium from building up. These include sodium zirconium cyclosilicate (Lokelma) or patiromer (Veltassa). Too much potassium in the blood can cause irregular heartbeats, called arrhythmias, and muscle weakness.
- Medicines to restore blood calcium levels. If the levels of calcium in your blood drop too low, you might need to get calcium through a vein, called an infusion.
Treatment to remove poisons from your blood. If wastes build up in your blood, you may need hemodialysis for a time. Also called dialysis, it helps remove poisons and excess fluids from your body while your kidneys heal.
Dialysis also may help remove excess potassium from your body. During dialysis, a machine pumps blood out of your body through an artificial kidney, called a dialyzer, that filters out waste. The blood is then returned to your body.
Lifestyle and home remedies
During your recovery from acute kidney injury, a special diet can help support your kidneys and limit the work they must do. Your healthcare team may send you to a dietitian. A dietitian can look at what you eat and suggest ways to make your diet easier on your kidneys.
Your dietitian may suggest that you:
- Choose foods lower in potassium. These include apples, peaches, carrots, green beans and white bread and white rice. Eat them instead of foods higher in potassium. These include potatoes, bananas, tomatoes, oranges, beans and nuts.
- Don't eat foods with added salt. This includes many packaged foods, such as frozen dinners, canned soups and fast foods. Other foods with added salt include salty snack foods, canned vegetables, and processed meats and cheeses.
- Limit phosphorus. Phosphorus is a mineral found in foods, such as dark-colored sodas, milk, oatmeal and bran cereals. Too much phosphorus in your blood can weaken your bones and cause your skin to itch.
As your kidneys get better, you may no longer need a special diet. But healthy eating still is important.
Preparing for your appointment
Most people are in a hospital when they get acute kidney injury. If you aren't in the hospital and have symptoms of kidney failure, make an appointment with your family healthcare professional right away. You may be referred to a specialist in kidney disease, called a nephrologist.
Before your appointment, write down questions. Consider asking:
- What's the most likely cause of my symptoms?
- Have my kidneys stopped working? What could have caused my kidney failure?
- What tests do I need?
- What are my treatment choices, and what are the risks?
- Do I need to go to the hospital?
- Will my kidneys recover or will I need dialysis?
- I have other health conditions. How can I best manage these conditions together?
- Do I need to eat a special diet? If so, can you refer me to a dietitian to help me plan what to eat?
- Do you have printed materials about acute kidney injury that I can have? What websites do you suggest?