Acute kidney injury - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Acute kidney injury (AKI) is commonly associated with sepsis, cardiovascular collapse, congestive heart failure, major surgery, nephrotoxins (such as antibiotics, intravenous contrast, or other drugs), or urinary outflow obstruction.
May present with flank pain, hematuria, hypertension or hypotension, edema, lethargy, uremia, or decreased urine output; however, often asymptomatic and only diagnosed by laboratory tests.
An acute increase in serum creatinine is essential for diagnosis. Fluid overload, hyperkalemia, hyperphosphatemia, metabolic acidosis, and elevated urea nitrogen are common.
The mainstay of treatment is supportive care, with management of the underlying illness; correction of acid/base, electrolyte, and volume complications; removal or minimization of nephrotoxins; and relief of any associated obstruction being key.
Renal replacement therapy with dialysis may be required and is usually well tolerated.

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Definition

Epidemiology

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Pathophysiology

Citations

Key Articles

Kidney disease: improving global outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO clinical practice guideline for acute kidney injury. Kidney Int Suppl. 2012 Mar;2(1):1-138.[Full Text]
Palevsky PM, Liu KD, Brophy PD, et al. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for acute kidney injury. Am J Kidney Dis. 2013 May;61(5):649-72.[Abstract][Full Text]
National Institute for Health and Care Excellence. Acute kidney injury: prevention, detection and management. Dec 2019 [internet publication].[Full Text]
National Institute for Health and Care Excellence. Acute kidney injury: prevention, detection and management. Dec 2019 [internet publication].[Full Text]
Moore PK, Hsu RK, Liu KD. Management of acute kidney injury: core curriculum 2018. Am J Kidney Dis. 2018 Jul;72(1):136-48.[Abstract][Full Text]

Other Online Resources

Fractional excretion of urea: calculator
KDIGO clinical practice guideline for glomerulonephritis

Referenced Articles

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