What practice nurses need to know about acute kidney injury

Abstract

Acute kidney injury is commonly seen in the community. Peter Ellis looks at the issues practice nurses might want to consider in its management in the community and when referral is necessary

The true prevalence of acute kidney injury (AKI) is uncertain, but the incidence is on the increase. The signs and symptoms of AKI vary according to the exact cause of the injury, but in the community the presenting signs will usually include the patient complaining of a reduced urine output. The signs and symptoms of AKI, including oliguria, tend to have a rapid onset. There are a large number of potential causes of AKI. An understanding of the cause and classification of a particular presentation of AKI will provide the practice nurse with useful clues as to its management. The key to management of AKI in the primary care setting is the removal, or reversal, of its cause, if possible. There is a degree of clinical interpretation that needs to be applied to the referral criteria, which will be informed by the patient's age and comorbidities and the nurse's experience of their care needs and the clinical support available in the general practice. People who recover from AKI require life-long monitoring for complications.