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Warning-sign checks

Acute kidney failure: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Severe breathing difficulty, chest pain, fainting, seizure, or marked confusion requires emergency care.

    And for anyone, someone who:

    • is bleeding heavily and it will not stop with firm pressure
    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    Seek prompt advice for a clear drop in urine output, increasing swelling, persistent vomiting, or worsening weakness.

    And for anyone, someone who:

    • has a wound that is hot, spreading red, or leaking pus
  3. 3

    Does any of this apply?

    Book an appointment

    After hospital discharge or outpatient treatment, follow-up may include checks of creatinine, electrolytes, blood pressure, urine protein, body weight, and swelling.

    The timing depends on how severe the AKI was and whether kidney function was improving at discharge.

    Earlier testing is often needed after a significant episode.

    This does not replace earlier follow-up when it is clinically needed.

    Routine follow-up should also include a plan for future illnesses.

    Ask what to do if vomiting, diarrhea, fever, or poor fluid intake develops.

The article also says

Recovery may occur over days, weeks, or longer.

Feeling better does not always mean kidney function has returned to its previous level, so repeat blood and urine tests are important.

Kidney Disease: Improving Global Outcomes guidance advises assessing patients about three months after AKI for recovery, new chronic kidney disease, or worsening of existing kidney disease.

Ask the care team which medicines should be restarted, avoided, or monitored.

Some medicines that were paused during AKI remain useful for long-term heart, blood pressure, or kidney care once it is safe to resume them.

Every sign above is quoted from the sofidex article on Acute kidney failure. If you are not sure, err upward — it is always reasonable to be checked.