Skip to main content

Advertisement

Log in

ACUTE KIDNEY INJURY

The odyssey of risk stratification in acute kidney injury

  • News & Views
  • Published:

From Nature Reviews Nephrology

View current issue Sign up to alerts

A recent observational study reports that after cardiac surgery, clinical outcomes differ significantly between patients with the same stage of acute kidney injury (AKI) depending on the diagnosis criteria used: urine output, serum creatinine or both. This finding emphasizes the limitations of current criteria for AKI risk stratification and diagnosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1: The evolution of AKI definitions.

References

  1. Howitt, S. H. et al. The KDIGO acute kidney injury guidelines for cardiac surgery patients in critical care: a validation study. BMC Nephrol. 19, 149–156 (2018).

    Article  Google Scholar 

  2. Bellomo, R. et al. Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit. Care. 8, R204–R212 (2004).

    Article  Google Scholar 

  3. Mehta, R. L. et al. Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit. Care. 11, R31 (2007).

    Article  Google Scholar 

  4. Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney Int. Suppl. 2, 1–138 (2012).

    Article  Google Scholar 

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

    Article  Google Scholar 

  6. Haase, M., Kellum, J. A. & Ronco, C. Subclinical AKI — an emerging syndrome with important consequences. Nat. Rev. Nephrol. 8, 735–739 (2012).

    Article  CAS  Google Scholar 

  7. Kellum, J. A. et al. Classifying AKI by urine output versus serum creatinine level. J. Am. Soc. Nephrol. 26, 2231–2238 (2015).

    Article  CAS  Google Scholar 

  8. Mongero, L. et al. The effect of ultrafiltration on end-cardiopulmonary bypass hematocrit during cardiac surgery. Perfusion 33, 367–374 (2018).

    Article  Google Scholar 

  9. Husain-Syed, F. et al. Preoperative renal functional reserve predicts risk of acute kidney injury after cardiac operation. Ann. Thorac Surg. 105, 1094–1101 (2018).

    Article  Google Scholar 

  10. Husain-Syed, F. et al. Persistent decrease of renal functional reserve in patients after cardiac surgery-associated acute kidney injury despite clinical recovery. Nephrol. Dial Tranplant. https://doi.org/10.1093/ndt/gfy227 (2018).

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Claudio Ronco.

Ethics declarations

Competing interests

C.R. is a consultant for Ortho Clinical Diagnostics and Astute Medical, and has received honoraria for serving on the advisory board of Biomerieux. F. H.-S. declares no competing interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Husain-Syed, F., Ronco, C. The odyssey of risk stratification in acute kidney injury. Nat Rev Nephrol 14, 660–662 (2018). https://doi.org/10.1038/s41581-018-0053-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41581-018-0053-z

  • Springer Nature Limited

This article is cited by

Navigation