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May 17, 2021 | Farah Jassawalla

The Difference Between Acute and Chronic Kidney Disease

What Does Your Kidney Do For You?

A better question would be: What doesn’t it do?

Kidneys are the body’s major excretory organ and their principal function is to filter out blood and toxins. They’re also responsible for the production and adequate maturation of Red Blood Cells (RBCs).

Anything deemed as appropriate for the body will be filtered back and whatever the kidneys identify as harmful will be secreted out. Kidneys, therefore, regulate the body’s internal environment.

Kidney Diseases - The Difference

Most people are under the assumption that the most adequate form of treatment for any kidney disease would be dialysis. This is actually only true for end-stage kidney diseases - wherein the body’s own organs fall by 10-15% of their working capacities.

Acute Kidney Injury (AKI)

Formerly known as Acute Kidney Disease (AKD), Acute Kidney Injury (AKI) is a form of kidney disease that is triggered by ‘events.’ For example, by injury, medication, wounds, infection, and so forth.

AKI is often symptomatic with patients complaining of mental confusion, lethargy, and nausea. A few people might be asymptomatic and lab tests would be required to diagnose them.

This form of kidney disease takes on a rapid outline: Serum creatinine increases by 0.3% within the first 48 hours of the event, Blood Urea Nitrogen (BUN) also increases, and the Glomerular Filtration Rate (GFR) rapidly decreases within hours to days.

AKI is often diagnosed early on and therefore treated just as quickly. Your physician would identify the underlying event that caused the injury and work towards eliminating it. For example, if AKI developed due to tubular ischemia, the physician would try to laparoscopically remove the obstruction.

Chronic Kidney Disease (CKD)

As opposed to AKI, Chronic Kidney Disease (CKD) develops over a period of three months and is triggered by ‘conditions’ rather than events. For example, CKD might be a manifestation of diabetes, hypertension, or polycystic kidney disease.

Patients are usually asymptomatic at the time when the disease is progressing and are usually only diagnosed at the end stages of the disease. Why? Because an asymptomatic patient won’t be intuitive enough to go to a doctor for a renal exam.

CKD is therefore identified as an incidental finding. Renal biopsies and serum creatinine tests are usually ordered by the physician if they determine a known condition that leads to CKD.

Kidney damage is characterized by albuminuria, urine casts, imaging findings, or abnormal renal biopsy. Kidney damage is either assessed with radiographs or with renal biopsies. Another indication is the GFR - Decreased glomerular filtration rate (GFR) of less than 60 mL/min/1.73 m2 for at least 3 months.

Serum Creatinine Tests

Just remember that one in three people living in the United States runs a risk of developing kidney disease. Tests for AKI are usually undertaken immediately because of the manifestation of symptoms, but those for CKD are far less obvious.

To get your kidneys checked right and on time, your physician would suggest a Creatinine Urine Test. Creatinine is the chemical compound formed after energy-producing processes in the muscles.

Healthy kidneys are able to filter creatinine out of the blood. Creatinine is excreted in the urine.

Consult a Physician

The best course of action would be to routinely follow up with your primary care physician and have them assess your kidneys the way they see fit. They might require a history of medication (several drugs are nephrotoxic) or correlate symptoms with diseases.

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Farah Jassawalla

Farah Jassawalla is a graduate of the Lahore School of Economics. She is also a writer, and a healthcare enthusiast, having closely observed case studies while working with Lahore's thriving general physicians at their clinics.