Prerenal Kidney Failure

Excerpt

Prerenal kidney failure, also known as acute renal failure (ARF), or acute kidney injury (AKI), is an extensively researched concept that has undergone numerous revisions in the diagnosis over the last decade. There are at least 30 biochemical definitions that have existed for AKI. The contemporary definition of acute kidney injury is based on the clinical guidelines set forth by 2012 Kidney Disease: Improving Global Outcomes (KDIGO) organization.

KDIGO defines AKI by the use of three major criteria, which are; an increase in creatinine (Cr) higher than 0.3 mg/dl (26.5 umol/L) in 48 hours, a rise of creatine greater than 1.5 times the baseline (presumed to have occurred in the last seven days), and a decrease of urine volume of equal to or lesser than 0.5 ml/kg/hr. If one or more of these criteria are met, the patient can be diagnosed with an AKI. The third criterion (decline in urine output) is a topic of debate, as many healthy individuals would meet this criterion if they had limited fluid intake throughout the day. Therefore caution is advised in making the diagnosis solely off of the last criterion alone. It is important to remember that the authors of KDIGO criteria stress that although these guidelines provide a framework to diagnose AKI, they should not replace clinical gestalt.