Most of us are familiar with kidney disease as a chronic condition caused by diabetes, hypertension, or advanced age. But did you know that some kidney problems can develop in as little as a few days? Acute kidney injury, or AKI, is an abrupt loss of kidney function that could happen before you know it. Sounds scary, right? But there’s good news: AKI is usually reversible! Most of us are not even aware of the causes that contribute to AKI.
Here are 8 causes of kidney injury you should be aware of.
One of the most common (and overlooked) causes of AKI is dehydration. This is often seen in the heat of the summer. Not drinking enough water can lead to low blood volume and poor circulation. If this goes on for a prolonged period of time, they eventually result in low blood pressure and kidney injury.
It’s important to drink water and stay hydrated. By maintaining an adequate fluid intake you can prevent AKI.
In America, we liberally use a drug called ibuprofen (also branded under Advil & Motrin). This over-the-counter drug comes in various doses of 400 mg, 600 mg, and 800 mg. Its uses are manifold. People take them for headaches, dental pain, menstrual cramps, muscle aches, or arthritis. Patients also use it to reduce fever or relieve minor aches and pains due to the common cold.
But ibuprofen is NOT benign! It can cause constriction of the small arteries supplying your kidneys and result in kidney failure. It’s particularly common in young females taking ibuprofen around the clock for their menstrual cramps and elderly patients who use it regularly for their joint pain. I highly recommend that you speak to your doctor before taking it if you have any type of kidney problem.
They belong to a class of drug is called nonsteroidal anti-inflammatory drugs also known as NSAIDSs. Other examples, or cousin drugs of ibuprofen, that belong to this class are CELECOXIB, DICLOFEN AC, TORADAL and MELOXICAM. Dr. G highly recommends avoiding NSAIDS in those with underlying kidney disease!
IV Contrast or Dye
Doctors often use a radio contrast dye when doing a CT scan (also called IVC or intravenous contrast). This agent is used for CT scans (injected in your vein prior to the procedure) to enhance the visibility of your internal organs. This helps us to identify stones, masses, cancers, cysts and many other pathologies. Many people who are allergic to iodine shouldn’t take this as it can cause a severe allergic reaction.
Cardiologists use this for heart (coronary) angiogram in those with heart attacks. The contrast dye is injected through a vein in your leg, and it circulates through your heart in order for your cardiologist to see your coronary arteries.
For those with peripheral vascular disease who have poor blood supply to the legs, vascular surgeons will inject this into the leg arteries in order to get a good picture of the blood flow. Diabetes, obesity, hypertension and smoking are all risk factors for peripheral vascular disease.
If you ever hear the words “IV contrast” or “dye” and you have kidney disease, contact your kidney doctor before you allow them to inject the dye. Oftentimes your nephrologist can hydrate you with salt solution and give you a medicine which protects your kidneys beforehand to minimize the risk of kidney failure.
Severe Allergic Reactions
This is often seen with antibiotics. Don’t take antibiotics freely! It’s important to use them only when indicated by your physician. Common ones such as cephalosporins, penicillins and sulfa antibiotics can cause an allergic reaction in your kidneys. Taking them too often also contributes to antibiotic resistance, which makes these medications less effective over time.
Heart Failure or CHF
When you have congestive heart failure (CHF), the heart struggles to pump blood effectively. Fluid backs up into your lungs, belly, legs and even your kidney veins. This will eventually lead to kidney failure. Your cardiologist and nephrologist need to work hand and hand to manage this one!
Liver Disease or Cirrhosis
Cirrhosis, most commonly caused by drinking alcohol and advanced hepatitis, may also contribute to kidney injury. The liver produces a protein known as albumin. Albumin is the glue that keeps water inside the blood vessels. In advanced liver failure the liver doesn’t produce albumin. This causes water to leak out of our blood vessels. The decreased volume leads to low blood pressure and kidney failure.
Reality Check: It’s a great idea to check your BP regularly especially if you are on medications to lower it. Elevated blood pressure is a sure way to signal that there may be problems with your kidneys. For reading blood pressure, remember that each person is different and a healthy BP will vary depending upon your age and medical conditions.
Please also be mindful if you take meds to lower your BP. The goal is not to ‘drive down’ your BP with meds, the goal is to stabilize the systolic BP to nice healthy number. Once again it depends upon the person, the condition they are in and the age. Your doc can help guide you. Too low of a BP can lead to acute kidney failure.
Unfortunately any type of infection in our body – It doesn’t matter what type of infection: UTI’s, Pneumonia, Intra-abdominal infections and so on can all lead to kidney injury. Those who are hospitalized, especially for a serious condition that requires intensive care, are at higher risk for kidney injury.
Think You May Have Acute Kidney Injury?
If you recognize any of these causes of acute kidney injury, you should see your doctor as soon as possible. A nephrologist can help you address many of them as well. If you’re seeking a nephrologist in the Orange County area, call Dr. Gandotra’s office today to schedule an appointment: (714) 435-0150