How is it Diagnosed?
Acute Kidney Disease (AKD) encompasses a spectrum between acute kidney injury
(AKI) and chronic kidney disease (CKD), usually diagnosed when renal dysfunction lasts
7–90 days. Diagnosis starts with medical history focused on recent illnesses,
nephrotoxic drug exposure (NSAIDs, antibiotics), dehydration, or urinary obstruction.
Symptoms may include reduced urine output, fatigue, swelling, or confusion.
The primary diagnostic tool is a rise in serum creatinine, indicating impaired filtration.
Urinalysis helps determine etiology: presence of protein, red or white blood cells, or
casts can suggest glomerular, tubular, or interstitial damage. Blood urea nitrogen (BUN),
creatinine ratio, and estimated glomerular filtration rate (eGFR) are used to classify
severity.
Imaging, particularly renal ultrasound, assesses kidney size and rule out obstruction or
structural abnormalities. Additional tests such as fractional excretion of sodium (FeNa),
urine osmolality, and electrolyte levels assist in differentiating prerenal, intrinsic, or
postrenal causes.
In select cases, renal biopsy may be needed to confirm diagnosis, especially if
glomerulonephritis or interstitial nephritis is suspected. Early identification and
management are crucial to prevent progression to irreversible chronic kidney disease.