Acute kidney injury and its management

Abstract

Acute kidney injury (AKI) is a life-threatening disorder, but one which is potentially reversible. This syndrome is a frequent and serious complication of hospitalized patients. When severe enough to require renal replacement therapy, hospital mortality approaches 60% and recovery among survivors may be as poor as 50%. Moreover, recent evidence using uniform definitions and classifications have revealed that even less severe forms of AKI are associated with reduced survival and other long-term adverse consequences, including progression of chronic kidney disease. Promising new biomarkers are becoming available and new strategies for prevention of AKI in specific situations are being developed. Advanced treatment options, including adsorptive therapy, the renal tubular assist device and stem cell therapy, are also on the horizon. Increasing knowledge in this field is beginning to fill in the missing jigsaw puzzle pieces and a more coherent picture is emerging. Challenges in management of AKI to reduce mortality are sill daunting, however, and more research is urgently needed. The combination of education, risk stratification, prevention, early detection, prompt therapeutic intervention, quality of supportive care, and innovative therapies offer the promise of improving outcomes in patients afflicted with this serious condition.