Diagnosis and Management of Acute Kidney Injury

Over the last decade, there has been a paradigm shift in our understanding of acute renal failure or acute kidney injury (AKI). Initially described and defined as a complete loss of kidney function, it is now widely recognized that lesser degrees of kidney injury have important implications for health. As currently defined, AKI represents a heterogeneous clinical syndrome with multiple etiologies rather than a specific disease. However whether it occurs in critically ill patients with multisystem organ failure or in isolation, AKI is associated with high costs and adverse clinical outcomes including excess mortality, increased length of hospital stay, the development and/or progression of chronic kidney disease (CKD), and requirement for chronic dialysis in survivors [1–4]. In its most severe form (requirement for acute dialysis), AKI is associated with mortality ranging from 15 % in patients presenting with isolated AKI to as high as to 80 % in critically ill patients [5].