Causes and Risk Factors of Acute Kidney Injury
Causes and Risk Factors of Acute Kidney Injury (AKI) is a serious and often sudden decline in kidney function. It’s not a standalone disease, but rather a clinical syndrome caused by a variety of underlying factors that impair the kidneys’ ability to filter waste and balance fluids and electrolytes. Understanding the causes and risk factors of acute kidney injury is crucial for early detection and effective treatment — especially in South Africa, where limited healthcare resources can lead to delayed diagnosis.
AKI is broadly classified into three main categories: pre-renal, intrinsic (renal), and post-renal causes.
Pre-renal AKI occurs when there is a significant drop in blood flow to the kidneys. This is often due to severe dehydration, major blood loss, or conditions that lead to low blood pressure, such as shock or heart failure. Liver failure can also contribute. These causes are typically reversible if recognised and treated early, but delays can result in lasting damage.
Intrinsic AKI involves direct injury to the kidney tissue itself. Infections like sepsis and HIV-related nephropathy are major contributors in South Africa. The use of nephrotoxic medications — such as NSAIDs, certain antibiotics, and contrast dyes used in medical imaging — can also lead to intrinsic kidney damage. Autoimmune diseases like lupus further increase the risk by causing inflammation within the kidneys.
Post-renal AKI is caused by a physical blockage of urine flow, which leads to a build-up of pressure and damage. This can result from an enlarged prostate (BPH), kidney stones, pelvic tumours, or traumatic injury to the urinary tract.
Several risk factors make individuals more susceptible to acute kidney injury. These include:
- Age over 65
- Pre-existing conditions like diabetes or high blood pressure
- Chronic kidney disease
- HIV or tuberculosis, particularly in the South African context
- Major surgery or physical trauma
- Use of nephrotoxic drugs
- Severe infections such as malaria or COVID-19 complications
In many South African rural hospitals, limited access to IV hydration, laboratory testing, and urgent referral services contributes to preventable deaths. Educating both healthcare providers and communities about the causes and risk factors of acute kidney injury can help save lives through faster recognition and treatment.
🔹 Next → [Symptoms and Early Warning Signs of AKI]
Causes of Chronic Kidney Disease
Diagnosis and Treatment of Acute Kidney Injury
