Acute Kidney Injury in Adults: An Underdiagnosed Condition

Kristy Washinger; MSN; FNP-BC


Journal for Nurse Practitioners. 2017;13(10):667-674. 

In This Article

Clinical Presentation

The presentation will depend on the underlying cause and severity of AKI and can range from a small increase in serum creatinine to anuric kidney failure requiring RRT. Common symptoms include malaise, altered mental status, anorexia, nausea, and vomiting. More advanced symptoms include myoclonic jerks and asterixis.[9] Obtaining a complete history is vital in establishing a correct diagnosis.

Important history includes comorbidities; medication use including over-the-counter medications, herbals, and prescription medications; urinary symptoms including frequency, dysuria, oliguria, anuria, hematuria, and/or incontinence; alterations in blood pressure including orthostasis; symptoms related to fluid loss (hemorrhage, polyuria, vomiting, diarrhea, and decreased oral intake); and fluid overload symptoms (dyspnea and edema).

A careful physical examination includes assessment of all systems, with particular attention to volume status. Table 4, available online at provides more detailed symptoms and physical examination findings.