Acute kidney injury treatment (Management of acute kidney injury (AKI))
Urgent treatment to support the kidneys, find and reverse the cause of a sudden drop in kidney function, and protect the kidneys while they recover.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- AKI is a sudden drop in kidney function and is usually caused by another illness, dehydration, a medicine or a blockage.
- Treatment focuses on finding and reversing the cause, supporting the kidneys and avoiding further harm — not a single fix.
- Many people recover, but some are left with reduced kidney function, so follow-up blood tests matter.
- AKI is an urgent problem: if you are passing very little urine, very unwell or confused, seek medical help straight away.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your specialist will give you advice for your situation.
Finds and treats the cause of the sudden drop in kidney function
AKI is an urgent problem; it is not something to manage at home without assessment when you are unwell or passing little urine.
The cause is treated and the kidneys are supported. Blood tests are repeated often to watch creatinine, salts and fluid balance.
A clear, written medicines plan stating what to take, restart or avoid.
The cause is treated and the kidneys are supported. Blood tests are repeated often to watch creatinine, salts and...
As the cause improves, kidney function often begins to recover. Paused medicines are reviewed and restarted when...
Before leaving hospital, you should be told which medicines to take, which were stopped, and when your kidneys...
A review checks your blood pressure, a urine test for protein, and a blood test for kidney function, to see...
What is acute kidney injury treatment?
Acute kidney injury (AKI) is a sudden, recent drop in how well the kidneys are working. It is common in people who are unwell, and about one in five people admitted to hospital as an emergency has some degree of AKI. It is usually a sign that something else is wrong, such as dehydration, infection, low blood pressure, a medicine, or a blockage to the flow of urine.
Treatment is not a single operation. It means quickly finding and treating the cause, supporting the kidneys, and protecting them from further harm while they recover. This often involves fluids, treating any infection, stopping medicines that can stress the kidneys, and carefully tracking blood tests.
Most AKI is picked up on a blood test that measures creatinine, a waste product the kidneys normally clear. Many people recover kidney function, but not everyone returns fully to their previous level, and AKI is taken seriously because it can be life-threatening if severe.
This guide explains what AKI treatment involves, how the kidneys are monitored, and the warning signs that mean you should seek help quickly.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Options at a glance
These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.
Reduced blood flow to the kidneys
Often called pre-renal AKI. Caused by dehydration, severe infection, blood loss or low blood pressure. Treatment focuses on restoring fluid and blood pressure and treating...
Direct kidney damage
Damage within the kidney tissue itself, sometimes from severe illness, certain medicines or inflammation. Treatment depends on the specific cause and may need a kidney...
A blockage to urine flow
Sometimes called post-renal AKI. Caused by something blocking the flow of urine, such as an enlarged prostate, stones or a tumour. Relieving the blockage is the key treatment.
Supportive treatment
Fluids given by mouth or into a vein, careful balancing of salts and fluids, and stopping or pausing medicines that can stress the kidneys while they recover.
Preparing for your treatment
- AKI is usually unplanned, so the first step is getting urgent medical help if you are unwell.
- Bring a full list of your medicines, including any bought without a prescription, as some can stress the kidneys.
- Tell the team about recent illness, vomiting, diarrhoea, reduced drinking, or new medicines or scans with contrast dye.
- Mention any kidney problems, diabetes, heart failure, high blood pressure or prostate symptoms.
- Say whether you have noticed passing less urine, swelling, or being unusually drowsy or confused.
- If you are normally under a kidney team, let staff know so they can be involved.
What happens
AKI is usually found through a blood test measuring creatinine, often alongside a check of your salts (such as potassium). You may also be asked for a urine sample and, if a blockage is suspected, an ultrasound scan of the kidneys.
The team works to find the cause and treat it: giving fluids if you are dry, treating infection, relieving a blockage (sometimes with a catheter), and reviewing your medicines. Some medicines are paused because they can stress the kidneys during an illness.
Your kidney function, fluid balance and salts are tracked closely with repeat blood tests. If the AKI is severe — for example if potassium or fluid build-up becomes dangerous — temporary dialysis may be started while the kidneys recover. A kidney specialist (nephrologist) is involved when the cause is unclear or the AKI is severe.
Is this treatment right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- AKI is an urgent problem; it is not something to manage at home without assessment when you are unwell or passing little urine.
- A planned private outpatient appointment is the wrong setting for someone acutely unwell with possible severe AKI, who needs emergency assessment.
- Treating AKI without finding the cause is not appropriate, because the underlying problem must be addressed.
- Restarting paused medicines without checking kidney function may not be safe.
Delay or rearrange if…
- Do not delay seeking help if you are very unwell, drowsy or passing little urine — this needs urgent assessment.
- Restarting kidney-stressing medicines should wait until kidney function is stable and confirmed by blood tests.
- Planned scans with contrast dye may need to be delayed or adjusted until kidney function recovers.
- Non-urgent procedures may be postponed until the AKI and its cause are treated.
Alternatives to discuss
- Treating the underlying cause, such as infection, dehydration or a blockage, is the core approach rather than an alternative.
- Supportive care with fluids and medicine review for milder AKI, avoiding more invasive treatment.
- Temporary dialysis only when needed for severe AKI, with a plan to stop as the kidneys recover.
- A conservative, comfort-focused plan in people who are very frail or near the end of life, decided with the patient and family.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Benefits
- Finds and treats the cause of the sudden drop in kidney function
- Supports the kidneys and helps prevent further harm while they recover
- Corrects dangerous fluid build-up or salt imbalances, such as high potassium
- Gives the best chance of kidney function recovering
- Sets up follow-up so any lasting kidney problem is picked up and managed
Risks & complications
- Repeated blood tests and close monitoring while in hospital
- Temporary changes to your usual medicines, some of which are paused
- Feeling unwell from the underlying illness that caused the AKI
- Needing a urinary catheter if a blockage or fluid monitoring is required
- Kidney function not returning fully to its previous level
- Build-up of fluid causing swelling or breathlessness
- Dangerously high potassium, which needs urgent treatment
- Needing temporary dialysis in more severe cases
- Long-term need for dialysis if the kidneys do not recover
- Severe, life-threatening illness when AKI is part of critical illness
- Complications of dialysis access or treatment, if dialysis is needed
The biggest concerns in AKI are the underlying illness that caused it and the risk that severe AKI can be life-threatening. Even after apparent recovery, AKI can leave the kidneys more vulnerable and raises the future risk of chronic kidney disease, so follow-up matters. Ask which of your medicines should be paused, when they can be restarted, and how your kidneys will be checked afterwards.
Published figures to discuss
Outcomes in AKI vary widely with the cause, how severe it is, how quickly it is treated, and other health conditions. The figures below come from hospital and research data and describe groups of patients, not any one person. They are included to set honest expectations, not to predict an individual outcome.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| In-hospital death with AKI overall | Approaching around 25% in hospital data, and higher in severe or critical illness | This largely reflects how unwell people are from the illness causing the AKI, not the AKI alone. | The aftermath of AKI: long-term mortality and renal function — PMCncbi.nlm.nih.govPublished figure |
| Frequency of AKI among emergency hospital admissions | About 1 in 5 | Shows how common AKI is; many cases are mild and recover with prompt treatment. | The aftermath of AKI: long-term mortality and renal function — PMCncbi.nlm.nih.govPublished figure |
| Progressive chronic kidney disease after AKI | Markedly higher than after no AKI in surgical cohorts (for example around 7% versus under 1% over two years) | Risk is higher with pre-existing kidney disease or diabetes, which is why follow-up is advised. | The aftermath of AKI: long-term mortality and renal function — PMCncbi.nlm.nih.govPublished figure |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
Recovery from AKI depends on its cause and how severe it was. The focus is on monitoring kidney function as it responds to treatment, and on protecting the kidneys afterwards, rather than a fixed recovery timeline.
- Feeling tired and washed out while recovering from the illness that caused the AKI
- Needing repeat blood tests after leaving hospital to confirm recovery
- Restarting some medicines gradually once the kidneys are stable
- Being advised to drink sensibly and avoid certain medicines during future illnesses
- Kidney function improving over days to weeks rather than instantly
Aftercare
- Make sure you know which medicines were stopped and when they can be safely restarted.
- Attend the recommended blood test to recheck your kidney function and blood pressure.
- Drink enough fluids, especially in hot weather or if you have a tummy bug, unless told to limit fluids.
- Ask which over-the-counter painkillers to avoid, as some (like ibuprofen) can stress the kidneys.
- Follow 'sick day' advice if given: certain medicines may need pausing if you become unwell with vomiting or diarrhoea.
- Tell any clinician arranging a scan with contrast dye that you have had AKI.
- Keep a note of your kidney results so you and your GP can track them.
- A clear list of which medicines to take, restart or avoid
- The date and place of your follow-up kidney blood test
- Your GP informed about the AKI episode
- Sick-day advice for medicines if you become unwell
- Knowledge of which painkillers and remedies to avoid
- A note of your latest kidney results
- Who to contact if you feel unwell again
⚠ Get urgent help if…
- Passing very little or no urine — seek urgent medical help.
- Feeling very unwell, drowsy, confused or hard to wake.
- Severe breathlessness or swelling of the legs, ankles or face.
- A fast, irregular or pounding heartbeat, or muscle weakness (possible high potassium).
- Persistent vomiting or diarrhoea that stops you keeping fluids down.
- Severe pain in the side or lower tummy, or a complete inability to pass urine.
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your specialist gives you.
Results & realistic expectations
A good result is that the cause is treated, kidney function recovers towards your previous level, and any dangerous fluid or salt problems are corrected. Many people recover well, but recovery is not guaranteed: severe AKI carries a real risk to life, and some people are left with reduced kidney function or go on to develop chronic kidney disease.
Because AKI can leave the kidneys more vulnerable even after they seem to recover, follow-up blood tests are important. Your team should be clear about what your results mean and what monitoring you need.
How well the kidneys do in the long run depends on the cause, how severe the AKI was, and your other health conditions, such as diabetes, heart disease or existing kidney problems. Even after apparent recovery, having had AKI raises the future risk of chronic kidney disease, which is why monitoring is usually advised for a period afterwards. Looking after blood pressure, staying well hydrated and avoiding kidney-stressing medicines during illness all help.
Related tests, treatments or support
AKI treatment is closely tied to treating whatever caused it, such as an infection, heart problem or blockage, so care is often shared between teams. If a blockage is found, relieving it (for example with a catheter or a small drainage tube) is part of treatment. Where AKI is severe, kidney specialists and intensive care teams may be involved together.
Follow-up & long-term care
Follow-up usually involves a blood test to recheck kidney function and blood pressure, often within about three months, plus a urine test for protein. Many people are then monitored by their GP for up to around three years because of the higher future risk of chronic kidney disease. If kidney function does not recover, you may be referred to a kidney specialist for ongoing care.
- Periodic blood tests to monitor kidney function after recovery
- Blood pressure checks and treatment if needed
- A urine test for protein as advised
- A personal plan for which medicines to pause during future illnesses
- Avoiding kidney-stressing medicines, such as some painkillers, where possible
Repeat, follow-on and what comes next
- Kidney function is rechecked repeatedly because it can change quickly during the illness.
- Some people need more than one assessment to confirm whether recovery is complete.
- If recovery is incomplete, care may move to long-term chronic kidney disease management.
- Temporary dialysis can sometimes be stopped as the kidneys recover, but occasionally becomes long-term.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- A clear, written medicines plan stating what to take, restart or avoid.
- A named contact and a booked follow-up blood test for kidney function and blood pressure.
- Sick-day rules for pausing certain medicines during future illness.
- Information for other clinicians, including before any scan with contrast dye.
- Onward referral to a kidney specialist if recovery is incomplete.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Whether care is urgent hospital treatment or later outpatient follow-up
- The number and frequency of blood tests to track kidney function
- Scans such as a kidney ultrasound and who reports them
- Whether a kidney specialist (nephrologist) is involved
- Whether temporary dialysis or a procedure to relieve a blockage is needed
- Ongoing monitoring of blood pressure and kidney function afterwards
- The specialist fee and how many reviews are included, if seen privately
- The cost of blood tests and urine tests and who reports them
- Scan fees and the radiology reporting fee
- What happens, and what it costs, if dialysis or a procedure becomes necessary
- The plan and cost for follow-up monitoring of kidney function
- How urgent deterioration would be handled and where
- Whether ongoing care would transfer to the NHS
On the NHS? Acute kidney injury is treated urgently on the NHS, usually in hospital; private care is more relevant to follow-up monitoring or a specialist opinion afterwards than to the acute illness itself.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Not being told clearly which medicines were stopped and when to restart them.
- Being discharged without a plan for follow-up kidney blood tests.
- No explanation that AKI raises the future risk of chronic kidney disease.
- No sick-day advice about pausing certain medicines during future illness.
- Assuming a single normal result means the kidneys have fully recovered.
Marketing red flags
- Claims that a supplement, drip or detox can 'cleanse' or cure kidney injury.
- Offering non-urgent private management for someone who is acutely unwell and needs emergency care.
- Downplaying the need to find and treat the underlying cause.
- Promising full kidney recovery as a certainty.
Choosing a specialist safely
- Check the specialist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good specialist will welcome every one of these.
- What caused my acute kidney injury, and has it been fully treated?
- Which of my medicines were stopped, and when can I safely restart them?
- What do my kidney results mean, and when will they be rechecked?
- Do I need to see a kidney specialist?
- What should I do during a future illness to protect my kidneys?
- Am I now at risk of long-term kidney problems, and how will that be monitored?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the specialist who carries out my treatment, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this treatment not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Is acute kidney injury the same as kidney failure?
Will my kidneys go back to normal?
Why were some of my medicines stopped?
Do I need dialysis?
How can I protect my kidneys in the future?
Can AKI be treated privately?
Find a verified specialist for acute kidney injury treatment
Every consultant is GMC-checked and independently reviewed. Search by postcode and distance, or switch to a map. Ordered by rating, relevance and recency — never by who pays.
No verified consultants list this procedure yet — browse the full directory.
How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: Kidney Care UK — Acute kidney injury (AKI) UK Kidney Association — AKI guidelines UK Kidney Association — AKI clinical practice guideline (PDF) The aftermath of AKI: long-term mortality and renal function — PMC Recovery of kidney function in AKI — PMC NICE NG148 — Acute kidney injury: prevention, detection and management (2019)
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
Related guides: Chronic kidney disease treatment · Anaemia of kidney disease management · Diabetic kidney disease management · Glomerulonephritis management · Haemodialysis