Rehabilitation Therapy for Acute Kidney Damage

Acute kidney damage affects 20 % of hospitalized patients. Acute kidney injury is also associated with chronic kidney disease, cardiovascular disease, and end-stage kidney disease. Only some patients receive follow-up care and rehabilitation after acute kidney damage. It is vital to provide lifestyle changes, medications, blood pressure control, and education for the patients after episodes of acute kidney injury, as they are high-risk populations. This disease may cause complications and mortality if left untreated.

What Is Acute Kidney Damage?

Acute kidney damage is when the kidneys suddenly stop working within a few hours or days, causing kidney failure or loss of kidney function. Renal impairment for more than seven days but less than 90 days is referred to as acute kidney damage. Acute kidney damage is usually seen in older people associated with other serious illnesses decreasing urine output. However, it is also seen in children and young people. This disease requires early detection and prompt treatment, such as temporary dialysis, so the kidney returns to normal.

What Causes Acute Kidney Damage?

The three leading causes of acute kidney damage include the following.

Reduced Blood Flow to the Kidneys:

• Blood loss.

• Severe dehydration and excessive vomiting, and diarrhea.

• Serious burns.

• Heart and liver failure.

• Blood pressure medications.

• Drugs such as Aspirin, Ibuprofen, Naproxen.

Block in the Drainage of Kidneys:

• Enlarged prostate.

• Kidney stones.

• Blood clots in the urinary tract.

• Ovarian, bladder, cervical, or prostate tumors.

Direct Damage to the Kidneys:

• Cholesterol deposits.

• Drugs damaging the kidneys include NSAIDs, antibiotics, and chemotherapy.

• Glomerulonephritis (inflammation of the kidney filters).

• Auto-immune diseases such as lupus, vasculitis, scleroderma, and multiple myeloma.

What Are the Symptoms of Acute Kidney Damage?

The symptoms of acute kidney damage include the following.

• Decreased urine output.

• Swelling of legs, ankles, and feet.

• Tired and drowsiness.

• Loss of appetite.

• Shortness of breath.

• Confusion.

• Chest pain or pressure.

• Fever and muscle twitching.

• Joint pain.

• Coma or seizures in severe cases.

What Are the Complications of Acute Kidney Damage?

The complications of acute kidney damage or failure include the following.

1. Fluid buildup - Acute kidney damage causes fluid buildup in the body, causing shortness of breath.

2. Chest pain occurs when the lining of the heart gets inflamed.

3. Muscle weakness occurs when the body's fluid and electrolytes are not balanced, leading to paralysis and heart problems.

4. Acidic blood - The blood in the body has more acids due to kidney failure (metabolic acidosis).

5. Permanent kidney damage - Acute kidney damage may cause permanent or chronic kidney damage called end-stage renal disease if left untreated. This disease requires permanent dialysis or kidney transplant because the kidney stops working completely.

6. Death is a severe complication of untreated acute kidney damage.

How to Treat Acute Kidney Damage?

The treatment of acute kidney damage requires a hospital stay. The treatment options in the hospital include the following.

• Treating the underlying cause of acute kidney damage.

• IV fluids balance the fluids and electrolytes in the body.

• Diuretics are prescribed to remove extra fluids in the body.

• Calcium, glucose, or sodium polystyrene sulfonate prevents potassium accumulation in the body.

• Dialysis removes toxins, excess fluids, and potassium from the body until the kidneys heal and return to normal function.

What Is the Rehabilitation Therapy for Acute Kidney Damage?

Research suggests including management strategies and post-follow-up care to enhance recovery after acute kidney damage. However, the intensity of the follow-up care depends on the following risk factors.

• Patient-specific risk factors - Pre-existing hypertension, cardiovascular diseases, diabetes, older age, and recurrent episodes of acute kidney injury.

• Characteristics of acute kidney damage and episodes.

• Degree of kidney recovery.

The rehabilitation program should include the following strategies and therapies to prevent complications and promote faster renal recovery.

Renal Rehabilitation:

• Renal rehabilitation promotes a patient's physical, psychological, and social functioning and reduces mortality and morbidity.

• The renal rehabilitation program lasts for 6 to 12 weeks.

• The significant components of renal rehabilitation are exercise training (physiotherapy), diet and fluid management, pharmacological management, educational strategies, and psychological and vocational counseling.

Management Strategies:

• Patients should receive treatment to the etiology to promote renal recovery. For example, steroids, immunosuppressants, and cytotoxic drugs are used for renal recovery.

• Basic counseling on lifestyle and dietary changes to promote renal and cardiovascular health after acute kidney damage.

• Pharmacological management is essential for patients during follow-up.

• Dialysis-dependent patients should have individual regimens according to their needs.

Education Strategies:

• Patients with acute kidney damage, their caregivers, and family members are educated about the etiology, diagnosis, risk factors, and importance of follow-up to prevent further kidney damage.

• Patient education about health management and fluid maintenance should start early to promote recovery.

Lifestyle and Home Remedies During Recovery:

• Dieticians suggest a special diet favorable to the kidney during recovery.

• Lower potassium foods such as apples, cauliflower, peppers, strawberries, and grapes are recommended.

• Avoid potassium-rich foods such as bananas, oranges, tomatoes, spinach, and potatoes.

• In addition, avoid products with increased salt to lower the sodium intake.

• High phosphorus can weaken the bones, so dieticians recommend avoiding phosphorus until the kidney returns to normal function.

Importance of Exercises in Acute Kidney Damage:

Exercise and physiotherapy are essential in renal rehabilitation for patients who suffer acute kidney damage. The following are the effects of exercises.

• Anti-Oxidative Effects - Decreases lipid peroxidation and increases catalase and glutathione enzymes.

• Anti-Inflammatory Effects - Decreases macrophage infiltration and T-cell activation and increases anti-inflammatory myokines.

• Autophagy upregulation.

• Improve muscle strength, mobility, fitness, heart and lung function, and self-esteem.

• Reduces blood pressure and controls weight.

Dialysis in the Treatment of Acute Kidney Damage:

• Patients with acute kidney damage who require dialysis are admitted to the hospital or at a dialysis center under the care of a nephrologist (kidney specialist).

• Dialysis filters toxins and wastes from the blood with the help of a dialysis machine. Blood is circulated through the machine and cleaned before entering the patient's body.

• Blood pressure is monitored regularly, and weekly laboratory results help the rehabilitation team improve patients' recovery.

Conclusion

Acute kidney damage is a complex condition requiring more renal recovery treatments. An exercise rehabilitation program improves renal recovery after acute renal damage and reduces the risk of progression to chronic kidney disease. Researchers recommend that healthcare providers provide follow-up and rehabilitation for the survivors of acute kidney damage or injury.