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Inzidenz der akuten Nierenschädigung

Incidence of acute kidney injury

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Der Nephrologe Aims and scope

Zusammenfassung

Die Inzidenz der akuten Nierenschädigung („acute kidney injury“, AKI) nimmt sowohl in den Industrie- als auch in Entwicklungsländern deutlich zu. Aggressivere internistisch-medizinische und chirurgische Behandlungen und ältere Patienten mit höherer Komorbidität haben das AKI-Spektrum verändert und stellen eine Erklärung für die steigende Inzidenz dar. Die richtige Einschätzung dieser Inzidenz wird beeinträchtigt davon, dass eine gemeinsame Definition für akute Nierenschädigungen fehlt. Beschrieben werden die Probleme dieser gemeinsamen Definition, und die bis heute verfügbaren Daten zu AKI in stationären, intensivstationären und außerstationären Settings werden weiter zusammengefasst.

Abstract

The incidence of acute kidney injury (AKI) is clearly increasing both in industrial and developing countries. More aggressive medical and surgical interventions in an aging population that has more pre-existing co-morbid conditions have altered the spectrum of AKI and explains the increasing incidence. Estimation of the correct incidence of AKI is hampered by the lack of a common definition of acute kidney injury in the literature. This paper briefly describes the problems with this common definition and further summarizes the available data on AKI in the community, in-hospital and intensive care units as well as out-of-hospital settings as reported at present. The available data on the prognosis in each setting are discussed.

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Literatur

  1. Kellum JA, Levin N, Bouman C, Lameire N (2002) Developing a classification system for acute renal failure. Curr Opin Crit Care 8:509–514

    Article  PubMed  Google Scholar 

  2. Hoste EA, Schurgers M (2008) Epidemiology of acute kidney injury: how big is the problem? Crit Care Med 36:S146–S151

    Article  PubMed  Google Scholar 

  3. Bellomo R, Kellum JA, Ronco C (2007) Defining and classifying acute renal failure: from advocacy to consensus and validation of the RIFLE criteria. Intensive Care Med 33:409–413

    Article  PubMed  Google Scholar 

  4. Ricci Z, Cruz D, Ronco C (2008) The RIFLE criteria and mortality in acute kidney injury: A systematic review. Kidney Int 73:538–546

    Article  PubMed  CAS  Google Scholar 

  5. Lassnigg A, Schmidlin D, Mouhieddine M et al (2004) Minimal changes of serum creatinine predict prognosis in patients after cardiothoracic surgery: a prospective cohort study. J Am Soc Nephrol 15:1597–1605

    Article  PubMed  CAS  Google Scholar 

  6. Parikh CR, Coca SG, Wang Y et al (2008) Long-term prognosis of acute kidney injury after acute myocardial infarction. Arch Intern Med 168:987–995

    Article  PubMed  Google Scholar 

  7. Mehta RL, Kellum JA, Shah SV et al (2007) Acute kidney injury network: report of an initiative to improve outcomes in acute kidney injury. Crit Care 11:R31

    Article  PubMed  Google Scholar 

  8. Bagshaw SM, George C, Dinu I, Bellomo R (2008) A multi-centre evaluation of the RIFLE criteria for early acute kidney injury in critically ill patients. Nephrol Dial Transplant 23:1203–1210

    Article  PubMed  Google Scholar 

  9. Newhouse JH, Kho D, Rao QA, Starren J (2008) Frequency of serum creatinine changes in the absence of iodinated contrast material: implications for studies of contrast nephrotoxicity. AJR Am J Roentgenol 191:376–382

    Article  PubMed  Google Scholar 

  10. Hsu CY, McCulloch CE, Fan D et al (2007) Community-based incidence of acute renal failure. Kidney Int 72:208–212

    Article  PubMed  Google Scholar 

  11. Ali T, Khan I, Simpson W et al (2007) Incidence and outcomes in acute kidney injury: a comprehensive population-based study. J Am Soc Nephrol 18:1292–1298

    Article  PubMed  CAS  Google Scholar 

  12. Metcalfe W, Simpson M, Khan IH et al (2002) Acute renal failure requiring renal replacement therapy: incidence and outcome. QJM 95:579–583

    Article  PubMed  CAS  Google Scholar 

  13. Prescott GJ, Metcalfe W, Baharani J et al (2007) A prospective national study of acute renal failure treated with RRT: incidence, aetiology and outcomes. Nephrol Dial Transplant 22:2513–2519

    Article  PubMed  Google Scholar 

  14. Liano F, Pascual J (1996) Epidemiology of acute renal failure: a prospective, multicenter, community-based study. Madrid acute renal failure study group. Kidney Int 50:811–818

    Article  PubMed  CAS  Google Scholar 

  15. Obialo CI, Okonofua EC, Tayade AS, Riley LJ (2000) Epidemiology of de novo acute renal failure in hospitalized African Americans: comparing community-acquired vs hospital-acquired disease. Arch Intern Med 160:1309–1313

    Article  PubMed  CAS  Google Scholar 

  16. Sever MS, Vanholder R, Lameire N (2006) Management of crush-related injuries after disasters. N Engl J Med 354:1052–1063

    Article  PubMed  CAS  Google Scholar 

  17. Lynn RM, O’brien SJ, Taylor CM et al (2005) Childhood hemolytic uremic syndrome, United Kingdom and Ireland. Emerg Infect Dis 11:590–596

    PubMed  Google Scholar 

  18. Cerda J, Bagga A, Kher V, Chakravarthi RM (2008) The contrasting characteristics of acute kidney injury in developed and developing countries. Nat Clin Pract Nephrol 4:138–153

    Article  PubMed  Google Scholar 

  19. Naicker S, Aboud O, Gharbi MB (2008) Epidemiology of acute kidney injury in Africa. Semin Nephrol 28:348–353

    Article  PubMed  Google Scholar 

  20. Jha V, Rathi M (2008) Natural medicines causing acute kidney injury. Semin Nephrol 28:416–428

    Article  PubMed  Google Scholar 

  21. Jha V, Chugh KS (2008) Community-acquired acute kidney injury in Asia. Semin Nephrol 28:330–347

    Article  PubMed  Google Scholar 

  22. Hou SH, Bushinsky DA, Wish JB et al (1983) Hospital-acquired renal insufficiency: a prospective study. Am J Med 74:243–248

    Article  PubMed  CAS  Google Scholar 

  23. Nash K, Hafeez A, Hou S (2002) Hospital-acquired renal insufficiency. Am J Kidney Dis 39:930–936

    Article  PubMed  Google Scholar 

  24. Khan IH, Catto GR, Edward N, Macleod AM (1997) Acute renal failure: factors influencing nephrology referral and outcome. QJM 90:781–785

    PubMed  CAS  Google Scholar 

  25. Liano F, Junco E, Pascual J et al (1998) The spectrum of acute renal failure in the intensive care unit compared with that seen in other settings. The Madrid acute renal failure study group. Kidney Int Suppl 66:S16–S24

    PubMed  CAS  Google Scholar 

  26. Waikar SS, Curhan GC, Wald R et al (2006) Declining mortality in patients with acute renal failure, 1988 to 2002. J Am Soc Nephrol 17:1143–1150

    Article  PubMed  Google Scholar 

  27. Lameire N, Van BW, Vanholder R (2006) The rise of prevalence and the fall of mortality of patients with acute renal failure: what the analysis of two databases does and does not tell us. J Am Soc Nephrol 17:923–925

    Article  PubMed  Google Scholar 

  28. Xue JL, Daniels F, Star RA et al (2006) Incidence and mortality of acute renal failure in Medicare beneficiaries, 1992 to 2001. J Am Soc Nephrol 17:1135–1142

    Article  PubMed  Google Scholar 

  29. Jha V, Malhotra HS, Sakhuja V, Chugh KS (1992) Spectrum of hospital-acquired acute renal failure in the developing countries – chandigarh study. Q J Med 83:497–505

    PubMed  CAS  Google Scholar 

  30. Wang Y, Cui Z, Fan M (2005) Retrospective analysis on Chinese patients diagnosed with acute renal failure hospitalized during the last decade (1994-2003). Am J Nephrol 25:514–519

    Article  PubMed  Google Scholar 

  31. Joannidis M, Metnitz PG (2005) Epidemiology and natural history of acute renal failure in the ICU. Crit Care Clin 21:239–249

    Article  PubMed  Google Scholar 

  32. Abosaif NY, Tolba YA, Heap M et al (2005) The outcome of acute renal failure in the intensive care unit according to RIFLE: model application, sensitivity and predictability. Am J Kidney Dis 46:1038–1048

    Article  PubMed  Google Scholar 

  33. Uchino S, Kellum JA, Bellomo R et al (2005) Acute renal failure in critically ill patients: a multinational, multicenter study. JAMA 294:813–818

    Article  PubMed  CAS  Google Scholar 

  34. Schrier RW, Wang W (2004) Acute renal failure and sepsis. N Engl J Med 351:159–169

    Article  PubMed  CAS  Google Scholar 

  35. Ostermann M, Chang RW (2007) Acute kidney injury in the intensive care unit according to RIFLE. Crit Care Med 35:1837–1843

    Article  PubMed  Google Scholar 

  36. Cruz DN, Bolgan I, Perazella MA et al (2007) North East Italian Prospective Hospital Renal Outcome Survey on Acute Kidney Injury (NEiPHROS-AKI): targeting the problem with the RIFLE Criteria. Clin J Am Soc Nephrol 2:418–425

    Article  PubMed  Google Scholar 

  37. Ympa YP, Sakr Y, Reinhart K, Vincent JL (2005) Has mortality from acute renal failure decreased? A systematic review of the literature. Am J Med 118:827–832

    Article  PubMed  Google Scholar 

  38. Desegher A, Reynvoet E, Blot S (2006) Outcomes of patients treated with renal replacement therapy for acute kidney injury. Crit Care 10:296

    Article  Google Scholar 

  39. Hoste EA, Clermont G, Kersten A et al (2006) RIFLE criteria for acute kidney injury are associated with hospital mortality in critically ill patients: a cohort analysis. Crit Care 10:R73–R83

    Article  PubMed  Google Scholar 

  40. Uchino S, Bellomo R, Goldsmith D et al (2006) An assessment of the RIFLE criteria for acute renal failure in hospitalized patients. Crit Care Med 34:1913–1917

    Article  PubMed  Google Scholar 

  41. Lameire N, Van BW, Vanholder R (2006) The changing epidemiology of acute renal failure. Nat Clin Pract Nephrol 2:364–377

    Article  PubMed  Google Scholar 

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  1. University Hospital Gent, 185, De Pintelaan 4K4, 9000, Gent, Belgien

    N. Lameire MD, PhD

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  1. N. Lameire MD, PhD
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Correspondence to N. Lameire MD, PhD.

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Lameire, N. Inzidenz der akuten Nierenschädigung. Nephrologe 4, 101–106 (2009). https://doi.org/10.1007/s11560-008-0241-0

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