Acute kidney injury natural history, complications and prognosis

Certain forms of AKI such as contrast induced nephropathy, usually have a shorter course with creatinine peak in 3-5 days. Common complications of acute kidney injury include anemia, metabolic acidosis, anorexia, nausea and vomiting. In general, the majority of patients that survive the initial insult recover their kidney function within 30 days.

• Certain forms of AKI such as contrast induced nephropathy, usually have a shorter course with creatinine peak in 3-5 days.^[1]

• Common complications of acute kidney injury include:^[2][3][4][5]
  • Anemia
  • Anorexia
  • Nausea and vomiting
  • Upper gastrointestinal bleeding
  • Metabolic acidosis
  • Hyperkalemia
  • Pulmonary edema
  • Hyperphosphatemia
  • Risk of infectious disease

• Acute interstitial nephritis causing AKI can have a variable course, sometimes resolving with the withdrawal of the inciting agent and at times requiring several weeks to restore full renal function.
• Other forms related to a more severe systemic illness such as DIC, lupus, and RPGN often result in end-stage renal disease.^[6]
• In general, the majority of patients that survive the initial insult recover their kidney function within 30 days.^[6]
• Beyond two months, patients usually will not recover their full renal function but might have some improvement that allows them to be free of renal replacement therapy.^[7][8]
• Despite the natural history showing possible recovery of renal function, AKI is associated with high mortality.
• AKI is also associated with increased length of hospital stay and costs.^[1]

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