ACUTE KIDNEY INJURY

It describes the situation where there is sudden and often reversible loss of renal function, which develops over days or weeks and is often accompanied by a reduction in urine volume.

The outcome is usually determined by the severity of the underlying disorder and their complications, rather than by kidney injury itself. Elderly patients are at higher risk of developing acute renal injury and have worse outcome.

CAUSES OF ACUTE KIDNEY INJURY :

• Pre-renal; when perfusion to the kidney is reduced, there is reduction in perfusion to GFR. If it’s not corrected may result in jury of kidney also known as acute tubular necrosis.

1. Cardiac failure
2. Sepsis
3. Blood loss
4. Dehydration
5. Vascular occlusion

• Renal; when the primary insult affects the kidney itself. Among them the common cause of renal is glomerulo-nephritis, in which there is direct inflammatory damage to the glomeruli.

1. Drugs
2. Toxins
3. Prolongs hypotension interstitial nephritis.
4. Inflammatory diseases

• Post-renal; when there is obstruction to urine flow at any point from the tubule to the urethra. This leads to elevation of intraluminal ureteral pressure transmitted to the nephrons after prolonged obstruction, with subsequent fall in GFR.

1. Urinary calculi
2. Retroperitoneal fibrosis
3. Benign prostatic Enlargement
4. Bladder cancer
5. Cervical cancer
6. Urethral stricture or valves
7. Meatal stenosis or phimosis

SIGN AND SYMPTOMS  OF ACUTE KIDNEY INJURY

PRE-RENAL:

• vomiting
• diarrhea
• burns
• hemorrhage
• liver diseases
• cardiac failure
• low blood pressure
• tachycardia
• weight loss
• dry mucous membrane and increase skin turgor
• JVP (jugular vein pulse) not visible even in lying down

RENAL:

• Rashes
• Weight loss
• Arthralgia
• Chest symptoms ( pulmonary renal syndrome)
• Hypertension
• Edema
• Purpuric rash
• Uveitis

Post renal:

• Distended bladder
• Any obstruction above the level of the bladder.

HOMOEOPATHIC MEDICINE FOR THE ACUTE KIDNEY INJURY

APIS MELLIFICA: Swelling or puffing up of various parts, edema, red rosy hue, stinging pains, soreness, intolerance of heat, and slightest touch, and afternoon aggravation are some of the general guiding symptoms. Burning and soreness when urinating. Suppressed, loaded with casts; frequent and involuntary; stinging pain and strangury; scanty, high colored. Incontinence. Last drops burn and smart.  Sudden puffing up of whole body.

CROTALUS HORRIDUS:  Has a profound trophic action. Low septic states. General disorganization of the blood, hćmorrhages and jaundice. Dark, bloody urine. Casts. Inflamed kidney. Albuminous, dark, scanty. Action feeble, pulse tremulous. Palpitation, especially at menstrual period. Trembling feeling of heart.