Checking for acute kidney injury

People with an acute or sudden illness

Sometimes, people who have been unwell for only a short time (that is, they have an acute illness) develop acute kidney injury.

If you have an acute or sudden illness that is worse than a cold or flu, your healthcare professional should check for acute kidney injury if:

  • you have long-term kidney problems (chronic kidney disease), heart failure, liver disease, or diabetes, or

  • you are passing only a small amount of urine, or

  • you rely on a carer for fluids, or

  • you have taken prescription or over-the-counter drugs that may affect the kidneys within the past week (examples include some drugs for high blood pressure and heart conditions, some antibiotics and ibuprofen), or

  • you have had acute kidney injury before (known as acute renal failure in the past), or

  • you have symptoms of blocked waterworks (urinary tract), or have had blocked waterworks before, or

  • you have a severe infection, or

  • you are 65 or over.

If you're an adult, your healthcare professional may also check for acute kidney injury if you have had any scan using an injection of dye (contrast medium) containing iodine within the past week. You can find out more information about this in the section called Risk in adults having a scan.

Healthcare professionals should also check for acute kidney injury in children and young people if they have any of the following:

  • diarrhoea containing blood

  • signs of inflammation in the kidneys (for example, blood in the urine)

  • low blood pressure

  • cancer affecting the blood cells

  • reliance on a parent or carer for fluids because of young age.

The check should involve measuring the level of a substance called creatinine in your blood. A raised creatinine level is a sign of kidney injury.

Healthcare professionals may suggest that people with an infection or diarrhoea or vomiting (sickness) stop taking ACE inhibitors and ARBs (certain drugs used to treat high blood pressure and heart conditions) until they are clearly on the mend. This might reduce the chance of developing acute kidney injury. Healthcare professionals should explain all the possible risks and benefits of stopping these drugs.

People with no obvious acute illness

Sometimes people without an acute illness may develop acute kidney injury. Healthcare professionals should think about the possibility of acute kidney injury if you have:

  • chronic kidney disease

  • new or worsening problems with your waterworks

  • symptoms that might be complications of acute kidney injury (for example, not passing much urine, nausea and sickness, swelling of the legs or other parts of the body)

  • symptoms that might be due to an illness affecting the kidneys and other organs (called a multi-system illness) – for example, a new purple rash on the legs.

Healthcare professionals should not assume that a rise in blood creatinine level is due to chronic kidney disease. It may be a sign of acute kidney injury.

If you have chronic kidney disease or you have a disability and rely on a carer for fluids, you should be told about the risk of acute kidney injury:

  • after a bout of sickness and diarrhoea

  • after taking prescription or over-the-counter drugs that may affect the kidneys (for example, ibuprofen).

Parents and carers should be involved in the discussion if appropriate.

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