Acute Kidney Injury Research Paper

INTRODUCTION

AKI is a syndrome of rapid loss of kidney function and oliguria, which is associated with adverse patient outcomes. Acute kidney injury (AKI) is defined as a functional or structural abnormality of the kidney as determined by blood, urine or tissue tests or by imaging studies.AKI is estimated to occur in up to 15% of hospitalized patients and up to 60% of critically ill patients. Despite advances in health care, the incidence of AKI is increasing in both developed and developing countries which is associated with severe psychological and financial trauma (1).

The incidence of acute kidney injury (AKI) has increased over the past few decades and the reported incidence of AKI in different regions of the world is quite variable. In

The cultural, economic and geographical differences determine the epidemiology of AKI in different places. Thus, epidemiology of AKI differs from country to country and also varies from center to center within the same country. (2).

The ―Acute Dialysis Quality Initiative‖ (ADQI) expert group developed the

RIFLE classification for AKI, which was later modified by the ―Acute Kidney

In the KDIGO definition, the time frame for an absolute increase in SCr of 0.3 mg/dL (26.4 μmol/L) is retained from the Acute

Kidney Injury definition (48 hours) while the time frame for a 50% increase in SCr in the 7 days, was originally suggested by the RIFLE criteria. The KDIGO criteria only utilize changes in SCr and urine output, and not changes in GFR for staging, with the exception of children under the age of 18 years, for whom an acute decrease in estimated GFR to < 35 mL/min per 1.73 m² is included in the criteria for stage

3 AKI (14). As with the ―RIFLE and Acute Kidney Injury staging systems‖, patients should be classified according to criteria that result in the highest (i.e. most severe) stage of injury.

The definition and staging system for AKI

(A) AKI is defined by either an increase of SCr or an episode of oliguria:

 Increase of SCr> 0.3 mg/dL within 48 hours, or

 Increase of SCr by > 1.5-fold above baseline, known or assumed to have occurred within 7days, or

 Urine volume < 0.5 mL/kg/hour for 6