Abstract
Acute kidney injury (AKI) is frequent in hospitalised critically ill patients with a high incidence in ICU patients. It is associated with increased mortality, greater cost, prolonged intensive care and hospital stay and progress to development of chronic kidney disease. AKI is an independent risk factor for increased mortality and severe morbidity. Sepsis is a leading cause of AKI in critically ill patients. The management is still supportive and early recognition, haemodynamic optimisation, avoidance of nephrotoxic medications, treatment of the underlying cause and renal replacement therapy are important. AKI is a preventable and outcome can be improved by early diagnosis and effective management. The aim of this review is to provide a comprehensive update on recent evidence in the field of AKI in critically ill patients, including risk factors, causes, pathophysiology, diagnosis/classification, prevention and management.
Highlights
Acute kidney injury (AKI) is frequent in hospitalized critically ill patients and occurs in approximately 36% of intensive care patients
The incidence of AKI increased from 0.2 % in patients with 0–2 risk factors to 9.5 % in those with more than five risk factors, and this incidence increased with the number of risk factors
Since these various biomarkers indicate different mechanisms of injury and their syntheses are located in different sites, and they are activated with different kinetics following kidney injury[10] despite growing literature, there is no study that truly demonstrates their utility in clinical practice for critically ill patients at risk of AKI
Summary
K Raveendran1* Consultant in Anaesthesia and Intensive Care Barking Havering and Redbridge University Hospitals, Essex, United Kingdom. Acute kidney injury (AKI) is frequent in hospitalised critically ill patients with a high incidence in ICU patients. It is associated with increased mortality, greater cost, prolonged intensive care and hospital stay and progress to development of chronic kidney disease. AKI is an independent risk factor for increased mortality and severe morbidity. Sepsis is a leading cause of AKI in critically ill patients. AKI is a preventable and outcome can be improved by early diagnosis and effective management. The aim of this review is to provide a comprehensive update on recent evidence in the field of AKI in critically ill patients, including risk factors, causes, pathophysiology, diagnosis/classification, prevention and management
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