14.05 - Acute Kidney Injury

Abstract

Acute kidney injury (AKI), a sudden and sustained decrease in renal function is a common and devastating clinical entity with an increasing incidence and an unacceptably high mortality. Renal ischemia, sepsis, and exposure to a wide variety of toxicants are the most frequent causes of AKI. Chronic renal failure and distant organ effects may be under recognized sequel of AKI. Preventive strategies have been investigated largely for radiocontrast-mediated injury and include hydration, optimizing intravascular volume, and avoiding nephrotoxicants. Although progress has been made, the optimal prescription for renal replacement therapy (dialysis), including timing of initiation, dose, and modality, remain to be determined. Future basic and clinical studies are needed and should identify biomarkers that are altered early in the course of injury and provide prognostic information, effective specific treatments, preventative strategies, and optimal renal replacement therapy.