Improving long-term outcome of acute kidney injury

Abstract

Acute kidney injury (AKI), diagnosed by elevated serum creatinine and decreased urine output, is a syndrome with a broad spectrum of diseases. The new concept of AKI was proposed nearly 20 years ago for better describing critically ill patients with acute renal dysfunction in ICUs. The medium- to long-term prognosis of AKI has recently been investigated in regards of transition to chronic kidney disease (CKD), and prolonged AKI has been recognized as acute kidney diseases and disorders (AKD). Composite outcome of major adverse kidney event (MAKE) is widely used. As CKD is the strongest risk factor for developing AKI, and AKI is a major risk for developing CKD, i.e., AKI and CKD form a vicious cycle that acts as risk factors for each other. Therefore, AKI may better be recognized as a temporary, sudden worsening phase of prolonged and progressive renal impairment rather than being a reversible, short-term disease condition.