Are you familiar with what kind of kidney condition you or a loved one has? Kidney conditions are typically broken into two categories: acute (short-term) kidney injury or chronic (long-term) kidney disease. 

The primary difference between an acute kidney injury (AKI)  and chronic kidney disease (CKD) is the speed of onset and how long the condition lasts. An AKI is a rapid loss in kidney function over a period of hours, while CKD is a gradual loss usually over months or years. AKI is also often reversible, while CKD has no cure. Learn more about the differences between an AKI and CKD including the causes, symptoms, and treatments. 

What are the causes?

There are numerous causes for both AKI and CKD. AKI causes are usually associated with medication, illness, or an injury, while CKD usually results from a chronic illness such as diabetes or high blood pressure. 

Causes of AKI can be:

• Heart or liver failure
• Medications toxic to the kidneys, including some antibiotics and nonsteroidal anti-inflammatory drugs (NSAIDs)
• Severe kidney infections
• Urinary tract obstruction (prostate disease, metastatic cancer, kidney or bladder stones)

Examples of CKD causes include:

• Diabetes
• High blood pressure
• Glomerulonephritis (​​inflammation of or damage to the filtering part of the kidneys)
• Polycystic kidney disease
• Exposure to toxins

What are the symptoms?

AKI and CKD symptoms can affect areas throughout the entire body. AKI symptoms typically become severe quickly and may require immediate hospitalization, while many CKD patients don’t experience noticeable symptoms until later stages of the disease. 

Some common symptoms of both AKI and CKD include:

• Low or no urine output
• Blood in the urine
• Confusion
• Shortness of breath
• Swelling (usually of the legs, feet, ankles, and/or face)
• Excessive thirst (in patients with dehydration)
• Flank pain 
• Weakness
• Fatigue
• Poor appetite
• Nausea/vomiting

In some cases, AKI can cause seizures. Advanced CKD may also cause: itchy skin, muscle cramps, and breath that has an ammonia-type smell. 

AKI occasionally causes no noticeable symptoms, and CKD can remain asymptomatic for years, even decades, until advanced stages.

What are the treatments?

With proper and timely treatment, usually conducted in a hospital, AKI is often reversible. Untreated AKI can lead to respiratory failure, heart rhythm abnormalities and other serious complications. CKD is manageable with medication and healthy lifestyle choices but is progressive and currently irreversible. The main goals of CKD management are to address the underlying medical conditions and slow CKD progression. 

Treatment for AKI focuses on correcting the underlying cause(s), and may include:

• Intravenous fluids 
• Diuretics 
• Intravenous calcium 
• Hemodialysis 
• Stopping any nephrotoxic medications

Some CKD management techniques include: 

• High blood pressure and cholesterol medications
• Stopping nephrotoxic medications
• Monitoring and correcting water and electrolyte imbalances
• Taking vitamin D supplements 
• Treating kidney-related anemia and osteopathy
• Making dietary changes, such as lowering sodium and/or protein intake

Treatment for both conditions can involve some form of dialysis. 

Are CKD and AKI related?

CKD and AKI are related in that they can act upon one another. A severe AKI can cause permanent damage that leads to CKD, and a person with CKD is at a higher risk to experience an AKI. Both of these life-altering conditions can require immediate attention by a healthcare team and a lifelong commitment to change in order to manage the disease effectively.

*Myhre, J., & Sifris, D. (2022, March 29). Acute vs. Chronic Kidney Disease: What’s the Difference? Verywell Health. https://www.verywellhealth.com/acute-vs-chronic-kidney-disease-5221287

Haskell, R. (2021, January 31). Acute Kidney Injury and Chronic Kidney Disease – What’s the Difference? LNC. https://www.nursingcenter.com/ncblog/january-2020/acute-kidney-injury-and-chronic-kidney-disease