Prevention of acute kidney injury in the clinical practice: The whole at a glance

Abstract

The gradual formation and the final acceptance of a definition of acute kidney injury highlighted the importance of prevention as it contributed to the recording of its impact on the parameters of mortality, the economic burden on health systems, and the progression to chronic kidney disease. Prevention could be separated into general principles and specific clinical cases. The general principles include early diagnosis with the identification of predisposing factors and use of electronic warning and biomarker systems, adequate renal perfusion by administering fiuid and vasomotor drugs, and finally avoidance of nephrotoxicity and administration of nephroprotective drugs. More frequent clinical cases are the postoperative, and also contrast-induced acute kidney injury, which implies both assessments of contrast need and hydration depending on the level of renal function. Despite the ongoing acute kidney injury research, prevention remains the main parameter to address it and needs the utmost attention and application in clinical practice.