Sometimes a trip to the hospital comes as an unexpected surprise and other times it is planned. Either way, there are several things you should know about your kidneys before your hospital visit. Being an informed and empowered patient can go a long way when it comes to your overall health and the health of your kidneys, especially in the hospital setting.
Acute kidney injury (AKI) is a serious and common complication of hospitalization, resulting in an abrupt decrease in kidney function. Major causes of AKI include burns, shock, drug toxicity, sepsis, severe diarrhea and exposure to intravenous contrast dyes used in imaging procedures. AKI has been reported in one in five hospital admissions, and there are 35 million people discharged from hospitals each year.
While these numbers may seem daunting, the good news is that, unlike some conditions closely associated with hospitals, such as MRSA, there’s actually a whole lot you can do to protect your kidneys. While you may or may not know when you will next enter the hospital, there are certain kidney questions everyone should ask before a hospital stay. Here are five to consider:
- Am I taking any medications (including over-the counter medications)? Virtually all drugs have to be dosed on the basis of knowing your kidney function, so as your kidney function declines, doses of antibiotics, pain medication and anesthetics (just to name a few) may need to be adjusted. If you have been taking any non-steroidal anti-inflammatory drugs (NSAIDs), such as Motrin, Ibuprofen, Advil, Aleve, or Naprosyn, you must disclose them to your admitting and treating physician. These drugs can lead to complications of kidney disease, bleeding, fluid retention, high blood pressure, stomach ulcers, and wound complications. You should stop these medications prior to coming to the hospital. In addition, while aspirin seems to have little effect on the kidneys, taking aspirin prior to a surgical procedure can result in post-surgical complications, including bleeding. Diuretic or blood pressure medications should also be discussed to determine if these medications should be taken prior to admission. These medications can lead to kidney and blood pressure complications after hospital admission and you should make your physician aware of any diuretics and blood pressure medications that you are taking. Doses may be stopped or adjusted while you are in the hospital.
- What is my glomerular filtration rate (GFR)? You may be thinking, my GF-what? The GFR is an important number to know because it is the best estimate of your level of kidney function. This number reflects the rate by which your kidneys are removing wastes from your blood and is easy to calculate with a simple blood test for serum creatinine. This is then used to calculate your eGFR. Because blood testing is commonly done prior to hospitalization or upon admission, be sure to check your lab work or ask your health care team about this test.
- Will any radiology or catheterization procedures be done? The dye that is used in many radiology and catheterization procedures can injure the kidneys. You and your treating physicians need to know your GFR before undergoing these procedures.
- Do I have urination or prostate problems? One of the most common complications of being hospitalized is an inability to pass urine. This is known as urinary retention. If you have difficulties passing urine or get up frequently at night, let your physician know. Bladder infections should also be diagnosed prior to hospitalization in order to prevent problems with infections complicating your hospital stay. If you are going to have surgery, you should have a urinalysis prior to any hospitalization and any test abnormalities should be addressed before surgery is performed.
- Do I or any of my family members have a history of kidney disease or anesthetic complications? Family histories of kidney disease or complications due to anesthesia place you at greater risk for developing AKI in the hospital. Dye tests and kidney toxic drugs may be commonly used in the hospital and you should make your physicians and anesthesiologist aware of any family history. If you have experienced acute kidney injury in the past during a hospitalization, bring it to your physician’s attention.
Hospitals should be places of safe health care delivery and recovery from acute or chronic illness. You should also be a smart patient. Take inventory of your kidney health prior to coming to the hospital and share these answers with your health care practitioner so that they are reflected in your medical records. Learn more about acute kidney injury and the National Kidney Foundation by visiting www.kidney.org.
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