Acute kidney injury: symptoms, causes and which doctor to see

For acute kidney injury you can first see: Internal Medicine or Urology or Nephrology. In large hospitals, the Nephrology unit also deals with this. If you are not sure, a family doctor (general practitioner) can assess you first and refer you to the right specialist.

Common symptoms: a marked fall in the amount of urine; swelling of the legs and around the eyes; tiredness, nausea, loss of appetite; shortness of breath; confusion (in advanced cases). Symptoms vary from person to person; a doctor’s examination is needed for a diagnosis.

The most common causes: dehydration from vomiting, diarrhoea and not drinking enough; kidney damage from painkillers and some antibiotics; scans with contrast dye; sepsis and serious infections; urinary tract blockage from an enlarged prostate or stones; muscle breakdown; some herbal products. Only a doctor’s examination can determine the exact cause.

When the cause is removed, kidney function recovers within days to weeks in most patients. In severe cases temporary dialysis may be needed; some patients are left with lasting damage.

It is more common in: older people; people with chronic kidney disease; people with diabetes and heart failure; people taking many medicines.

Creatinine, urea, electrolytes, a urine test and a kidney ultrasound are done.

Drinking enough fluids, using painkillers carefully and telling the doctor about your kidney condition before scans with contrast.

It often improves once the cause is removed.

In severe cases, temporary dialysis may be needed.

Severe fluid loss can strain the kidneys, especially in older people and those taking blood pressure or diabetes medicines. Drink oral rehydration fluids and see a doctor the same day if you are passing very little urine.

If the answer to any of these questions is yes, call 112 without delay: “Have you passed almost no urine for 12 hours?” “Is there shortness of breath, chest pain, an irregular heartbeat or confusion?” “Is there confusion, fainting or difficulty waking up?” “Is there facial drooping, slurred speech or sudden weakness in an arm or leg?” “Are you struggling to breathe even at rest?”

See a doctor: the same day if your urine output has dropped; your creatinine level has risen; you have a chronic illness and have had diarrhoea and vomiting.