, Volume 40, Issue 2, pp 147-159

Year in review in Intensive Care Medicine 2013: I. Acute kidney injury, ultrasound, hemodynamics, cardiac arrest, transfusion, neurocritical care, and nutrition

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Acute kidney injury

Despite significant advance of knowledge in the field, acute kidney injury (AKI) still remains a syndrome with significant morbidity and mortality. The commonness of this syndrome in critically ill patients has been highlighted by the prospective FINNAKI study [1] including 2,901 patients from 17 Finnish ICUs, which found an AKI incidence of nearly 40 %. Hypovolemia, diuretics, artificial colloids, and chronic kidney disease were identified as major independent risk facts for developing AKI in the ICU. The study also confirmed that reversibility of AKI highly depends on the AKI stage at presentation with a 30 % resolution on the following day for AKI stage 1 and 87 % AKI persistence in patients with stage 3. Severity of hypotension and postoperative ventricular function appeared to be the major determining factors for developing renal damage in children undergoing cardiac surgery [2].

The long-lasting quest for a generally accepted definition and classification of AKI