Furthermore the syndrome is quite common among patients without critical illness and it is essential that health care professionals, particularly those without specialisation in renal disorders, detect it easily.Ĭlassification of AKI includes pre-renal AKI, acute post-renal obstructive nephropathy and intrinsic acute kidney diseases. Many patients with AKI have a mixed aetiology where the presence of sepsis, ischaemia and nephrotoxicity often co-exist and complicate recognition and treatment. It is a syndrome that rarely has a sole and distinct pathophysiology. AKI is defined as an abrupt (within hours) decrease in kidney function, which encompasses both injury (structural damage) and impairment (loss of function). 2 – 5Īcute Kidney Injury (AKI) is the term that has recently replaced the term ARF. However, recent evidence suggests that even relatively mild injury or impairment of kidney function manifested by small changes in serum creatinine (sCr) and/or urine output (UO), is a predictor of serious clinical consequences. Traditionally, emphasis was given to the most severe acute reduction in kidney function, as manifested by severe azotaemia and often by oliguria or anuria. The concept of Acute Renal Failure (ARF) 1 has undergone significant re-examination in recent years. In this review we provide the most recent updates in the definition, epidemiology and pathophysiology of AKI. Accurate and prompt recognition of AKI and better understanding of the pathophysiologic mechanisms underlying the various clinical phenotypes are of great importance to research for effective therapeutic interventions. Recent evidence, in both basic science and clinical research, is beginning to change our view for AKI from a single organ failure syndrome to a syndrome where the kidney plays an active role in the progress of multi-organ dysfunction. AKI is a syndrome that rarely has a sole and distinct pathophysiology. With this knowledge we will be able to conduct more accurate epidemiologic studies in an effort to gain a better understanding of the impact of this syndrome. Recent advances in clinical and basic research will help with a more accurate definition of this syndrome and in the elucidation of its pathogenesis. Acute kidney injury (AKI) is a clinical syndrome that complicates the course and worsens the outcome in a significant number of hospitalised patients.
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