Abstract
The term acute kidney injury (AKI) has been recently coined by a large panel of international experts in place of the former expression "acute renal failure". This change has been motivated by a double intention: first it served to definitely find a conventional definition for acute changes of renal function, previously lacking in the medical community. In fact, any attempt to compare scientific papers and different centres experiences on AKI was essentially impossible. The second aim was to remark that this syndrome is characterised by a spectrum of progressive damage, from mild creatinine increase to renal injury to a more severe form, failure: this important concept should increase clinicians awareness to every form of renal dysfunction, even milder ones, in order to improve epidemiologic analyses, potentially preventing eventual AKI progression and finally helping standardisation of medical and supportive therapy. This review will describe such "new era" of critical care nephrology by presenting current literature (and its many controversies) about AKI diagnosis, physiopathology and management.
Highlights
The term acute kidney injury (AKI) has been recently coined by a large panel of international experts in place of the former expression “acute renal failure”
The second aim was to remark that this syndrome is characterised by a spectrum of progressive damage, from mild creatinine increase to renal injury to a more severe form, failure: this important concept should increase clinicians awareness to every form of renal dysfunction, even milder ones, in order to improve epidemiologic analyses, potentially preventing eventual AKI progression and helping standardisation of medical and supportive therapy
A recent post hoc analysis [49], from the Fluid and Catheter Treatment Trial (FACTT) study, which evaluated a conservative versus liberal fluid management strategy in patients with acute lung injury, showed that a positive fluid balance after AKI was associated with 60-day mortality, that the risk of death in patients with acute lung injury and AKI was approximately 1.6-fold higher per liter/day of fluid accumulated and, Importantly, that diuretic use after AKI was associated with decreased mortality, with the protective effect on 60-day mortality being limited after adjustment for fluid balance
Summary
The term acute kidney injury (AKI) has been recently coined by a large panel of international experts in place of the former expression “acute renal failure”. This change has been motivated by a double intention: first it served to definitely find a conventional definition for acute changes of renal function, previously lacking in the medical community. The second aim was to remark that this syndrome is characterised by a spectrum of progressive damage, from mild creatinine increase to renal injury to a more severe form, failure: this important concept should increase clinicians awareness to every form of renal dysfunction, even milder ones, in order to improve epidemiologic analyses, potentially preventing eventual AKI progression and helping standardisation of medical and supportive therapy.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
