Disease
Acute Kidney Injury (AKI), also known as acute renal failure, is a sudden and severe decline in kidney function, occurring over hours or days. Unlike chronic kidney disease, which evolves slowly, AKI strikes quickly, often as a complication of another illness, surgery, or medication.
The kidneys are vital for filtering toxins, maintaining fluid balance, and regulating electrolytes. When they suddenly stop functioning properly, waste products and excess fluids accumulate rapidly, disrupting the body’s internal chemistry. This can lead to swelling, confusion, shortness of breath, and in severe cases, life-threatening complications.
AKI is typically reversible, especially if diagnosed and treated early, but its impact can be serious if neglected. It is often seen in hospitalized or critically ill patients, particularly those who have undergone surgery, severe infection (sepsis), or dehydration. In some cases, AKI may develop even in healthy individuals after severe dehydration, medication toxicity, or urinary blockage.
Dr Anish Kr. Saha’s approach to managing AKI focuses on rapid identification, cause-specific intervention, and vigilant monitoring. As a leading nephrologist, his first step is to determine whether the cause of kidney failure is due to decreased blood flow to the kidneys (prerenal), direct damage to the kidney tissue (intrinsic), or obstruction in the urinary tract (postrenal).
This classification allows for targeted and effective treatment, restoring blood flow, removing blockages, or discontinuing harmful medications, before irreversible damage occurs.
In Dr Anish Saha’s supervision, AKI care involves an integrated protocol:
Early diagnostic testing (serum creatinine, urine output, imaging).
Immediate management of the underlying trigger.
Close fluid and electrolyte monitoring.
Dialysis support when needed.
Because AKI can occur in anyone, from postoperative patients to those with infections or dehydration, awareness and prompt action are key. With expert intervention, most patients recover fully and regain normal kidney function within days or weeks.
Symptoms
The symptoms of Acute Kidney Injury can vary depending on the severity of the damage and the underlying cause. In many cases, AKI may appear suddenly, especially in patients who are already unwell.
Here are the common signs and symptoms:
Sudden reduction in urine output: Some patients may pass very little urine, while others may stop urinating altogether.
Swelling (edema): Fluid retention in legs, ankles, or around the eyes due to poor filtration.
Fatigue and confusion: Accumulation of toxins in the blood affects brain function and energy levels.
Shortness of breath: Caused by fluid accumulation in the lungs.
Nausea and vomiting: Waste buildup leads to digestive discomfort.
Chest pain or pressure: Fluid may collect around the heart.
Irregular heartbeat or muscle weakness: Result of abnormal potassium levels in the blood.
High blood pressure: The sudden rise or drop in pressure due to fluid imbalance.
In mild cases, symptoms may be subtle, a slight reduction in urination or swelling in the ankles, but in severe cases, AKI can cause life-threatening electrolyte disturbances and multiorgan failure if untreated.
Hospitalized patients often show early biochemical signs (increased serum creatinine or urea) before visible symptoms appear. Hence, routine monitoring of kidney function is essential during any major illness or surgery.
Dr Anish Kumar Saha, the best nephrologist in Siliguri, emphasizes that the key to AKI recovery is early recognition. Patients and healthcare teams must be alert to even minor changes in urine output, blood pressure, or hydration levels, as timely medical attention can completely reverse the damage in most cases.
Causes
AKI doesn’t arise from a single cause, it can be the outcome of multiple overlapping factors. To diagnose and manage it effectively, Dr Anish Kumar Saha, the best nephrologist in Siliguri, categorizes the causes into three broad groups:
1. Pre Renal (Reduced Blood Flow to the Kidneys):
The kidneys rely on a steady blood supply to filter waste. When blood flow drops suddenly, they become oxygen-deprived and stop functioning efficiently.
Common causes include:
Severe dehydration from vomiting, diarrhea, or fever.
Blood loss (hemorrhage) after surgery or trauma.
Low blood pressure due to shock, sepsis, or heart failure.
Use of diuretics or blood pressure medications that overly reduce blood volume.
If detected early, restoring blood flow can quickly reverse this type of kidney injury.
2. Intrinsic (Direct Damage to Kidney Tissue):
In this category, the problem lies within the kidneys themselves. The most common intrinsic causes are:
Acute Tubular Necrosis (ATN): The most frequent cause of AKI, often resulting from prolonged low blood pressure or exposure to toxins.
Glomerulonephritis: Inflammation of the kidney’s filtering units due to infections or autoimmune diseases.
Acute Interstitial Nephritis: Usually caused by allergic reactions to medications like antibiotics or NSAIDs.
Vascular Problems: Blockage or inflammation of the kidney blood vessels.
3. Post Renal (Obstruction of Urine Flow):
When urine cannot flow out of the kidneys due to blockage, pressure builds up, impairing filtration.
Typical causes include:
Kidney stones.
Enlarged prostate (in men).
Tumors or blood clots in the urinary tract.
Scarring of the ureters.
By identifying the cause category early, Dr Anish Kumar Saha, the best nephrologist in Siliguri customizes treatment, whether it’s fluid restoration, infection control, or surgical relief of obstruction, ensuring kidneys recover as swiftly and safely as possible.
When to See a Doctor
Acute Kidney Injury is a medical emergency, and delays can lead to irreversible complications. You should see a nephrologist like Dr Anish Kr. Saha, immediately, if you notice:
A sudden decrease or complete stop in urination.
Swelling in your legs, ankles, or around the eyes.
Persistent nausea, vomiting, or metallic taste in the mouth.
Shortness of breath or unexplained chest discomfort.
Extreme fatigue, confusion, or drowsiness.
Rapid changes in blood pressure.
Dark, foamy, or blood-tinged urine.
People who are at higher risk, such as those with chronic illnesses, diabetes, hypertension, heart disease, or recent major surgery, should be especially vigilant.
Even mild dehydration or medication misuse can trigger AKI in susceptible individuals. Dr Anish Kumar Saha, the best nephrologist in Siliguri, the best nephrologist in Siliguri, the best nephrologist in Siliguri, advises his patients to seek immediate medical care if they experience reduced urine output for more than 12–24 hours or if they’re recovering from an infection or surgery and notice swelling or lethargy.
His diagnosis is swift and precise, involving simple blood tests (creatinine, urea), urine analysis, ultrasound, and other imaging studies to pinpoint the cause and severity. Early detection can mean the difference between full recovery and lasting kidney impairment.
Treatments
The treatment of Acute Kidney Injury depends entirely on the underlying cause and the extent of damage. The central goal is to restore kidney function, correct fluid and electrolyte imbalances, and treat whatever triggered the problem in the first place.
Dr Anish Kumar Saha’s management strategy for AKI follows a step-by-step protocol that combines emergency care, supportive therapy, and long-term follow-up.
1. Stabilization and Supportive Care:
In the acute stage, maintaining blood pressure and adequate circulation is crucial. Patients may receive intravenous fluids to correct dehydration or medications to improve heart function and stabilize blood flow.
If fluid overload occurs, diuretics may be used carefully to remove excess fluid, but only under close medical supervision.
2. Identifying and Treating the Root Cause:
Once stabilized, Dr Anish Kumar Saha, the best nephrologist in Siliguri, focuses on reversing the cause:
For dehydration: Aggressive fluid replacement.
For sepsis or infection: Prompt antibiotic therapy.
For medication-induced AKI: Immediate discontinuation of the offending drug.
For obstruction: Catheterization, stent placement, or surgical removal of blockage.
3. Monitoring and Correction of Electrolytes:
AKI often leads to abnormal potassium, sodium, or acid levels, which can affect heart rhythm and muscle function. These are closely monitored and corrected through medications or dialysis if needed.
4. Dialysis (Temporary Renal Replacement Therapy):
When kidneys are unable to remove waste or maintain fluid balance, dialysis is initiated as a temporary measure. It removes toxins, balances electrolytes, and supports the body while the kidneys recover.
Dr Anish Kuamr Saha, the best nephrologist in Siliguri, ensures patients understand that dialysis in AKI is usually short-term and discontinued once normal function returns.
5. Nutritional and Fluid Management:
Patients received personalised dietary advice, restricting potassium, phosphorus, and salt, while ensuring adequate calories for recovery. Fluid intake is carefully balanced based on urine output and blood results.
6. Preventing Recurrence:
Once the acute phase resolves, Dr Anish Kumar Saha, the best nephrologist in Siliguri, educates patients about avoiding potential triggers:
Staying well-hydrated.
Avoiding overuse of painkillers and herbal supplements.
Monitor blood pressure and diabetes regularly.
Reporting early signs of infection or dehydration.
7. Long-Term Follow-Up:
Even after recovery, some patients may develop mild residual kidney impairment or be at risk for CKD. Dr Anish Kumar Saha, the best nephrologist in Siliguri, the best nephrologist in Siliguri, the best nephrologist in Siliguri, provides long-term follow-up care, including regular blood and urine tests, to ensure kidney function remains stable.