Systemic Manifestation and Clinical Presentation of AKI

Key systemic manifestations of AKI include:24

  • Fluid volume overload, infection, uraemia, and electrolyte imbalances (including hyperkalaemia, hyperphosphatemia, hypermagnesemia, hypernatremia, and metabolic acidosis)
  • Sodium retention, causing swelling of the feet and ankles
  • Protein leakage in the urine, causing puffiness around the eyes

Symptoms of AKI include high heart rate and low blood pressure. Immediate intervention involves rehydrating with water. Intravenous hydration with saline may be needed, depending on symptoms and the stage of AKI.

Symptoms of AKI can vary by underlying cause.

Mild (stage 1) and Moderate (stage 2) AKI may be asymptomatic and diagnosed by laboratory testing.

Severe (stage 3) AKI may present with symptoms that are subtle or nonspecific, occur individually or in clusters, or vary with age.

Symptoms of AKI

Infants or young childrenAdults
Dry mouth and tongueExtreme thirst
No tears when cryingDry mouth and/or dry cough
Dry diapers for ≥3 hoursReduced frequency of urination or dark-coloured urine
Sunken eyes or cheeksConstipation
Sunken soft spot on the top of the skullHigh heart rate, low blood pressure
Listlessness or irritabilityFatigue
Dizziness, weakness, or light-headedness
Headache, delirium, or confusion
Swollen feet
Muscle cramps
Diarrhoea for ≥24 hours
Persistent vomiting
Disorientation
Bloody or black stool

AKI is associated with a high rate of complications, progression to multiple organ dysfunction, and increased risk of mortality.24