Acute Kidney Injury (AKI)

  • Marcus HißEmail author
  • Jan T. Kielstein


Acute kidney injury (formerly known as acute renal failure) is a complex disorder with many underling conditions. It is seen in SIRS/sepsis and associated with a mortality of 60 % [1]. In 2007, a uniform definition was proposed which now replaces the more than 30 definitions that existed previously [2]. The diagnostic criteria for AKI were proposed based on acute alterations in serum creatinine or urine output. The Acute Kidney Injury Network (AKIN) criteria (Table 13.1) are based on epidemiological studies. Those studies indicated that modest changes in serum creatinine were significantly associated with mortality, hospital length of stay, and costs [3]. The old classification of prerenal, renal, and postrenal AKI is becoming less important as more than 90 % of the AKI patients suffer from a combination of prerenal and renal AKI.


Acute Renal Failure Renal Replacement Therapy Acute Kidney Injury Sodium Bicarbonate Modest Change 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Uchino S, Kellum JA, Bellomo R, Doig GS, Morimatsu H, Morgera S, Schetz M, Tan I, Bouman C, Macedo E, Gibney N, Tolwani A, Ronco C. Acute renal failure in critically ill patients: a multinational, multicenter study. JAMA. 2005;294:813–8.PubMedCrossRefGoogle Scholar
  2. 2.
    Mehta RL, Kellum JA, Shah SV, Molitoris BA, Ronco C, Warnock DG, Levin A. Acute Kidney Injury Network (AKIN): report of an initiative to improve outcomes in acute kidney injury. Crit Care. 2007;11:R31.PubMedCrossRefPubMedCentralGoogle Scholar
  3. 3.
    Chertow GM, Burdick E, Honour M, Bonventre JV, Bates DW. Acute kidney injury, mortality, length of stay, and costs in hospitalized patients. J Am Soc Nephrol. 2005;16:3365–70.PubMedCrossRefGoogle Scholar
  4. 4.
    Hsu RK, McCulloch CE, Dudley RA, Lo LJ, Hsu CY. Temporal changes in incidence of dialysis-requiring AKI. J Am Soc Nephrol. 2013;24:37–42.PubMedCrossRefGoogle Scholar
  5. 5.
    Kellum JA, Lameire N. Diagnosis, evaluation, and management of acute kidney injury: a KDIGO summary (part 1). Crit Care. 2013;17:204.PubMedCrossRefGoogle Scholar
  6. 6.
    Friedrich JO, Adhikari N, Herridge MS, Beyene J. Meta-analysis: low-dose dopamine increases urine output but does not prevent renal dysfunction or death. Ann Intern Med. 2005;142:510–24.PubMedCrossRefGoogle Scholar
  7. 7.
    Lassnigg A, Donner E, Grubhofer G, Presterl E, Druml W, Hiesmayr M. Lack of renoprotective effects of dopamine and furosemide during cardiac surgery. J Am Soc Nephrol. 2000;11:97–104.PubMedGoogle Scholar
  8. 8.
    Mehta RL, Pascual MT, Soroko S, Chertow GM. Diuretics, mortality, and nonrecovery of renal function in acute renal failure. JAMA. 2002;288:2547–53.PubMedCrossRefGoogle Scholar
  9. 9.
    Mehta RL, McDonald B, Gabbai F, Pahl M, Farkas A, Pascual MT, Zhuang S, Kaplan RM, Chertow GM. Nephrology consultation in acute renal failure: does timing matter? Am J Med. 2002;113:456–61.PubMedCrossRefGoogle Scholar
  10. 10.
    Bouchard J, Soroko SB, Chertow GM, Himmelfarb J, Ikizler TA, Paganini EP, Mehta RL. Fluid accumulation, survival and recovery of kidney function in critically ill patients with acute kidney injury. Kidney Int. 2009;76:422–7.PubMedCrossRefGoogle Scholar
  11. 11.
    Hsu CY, Chertow GM, McCulloch CE, Fan D, Ordonez JD, Go AS. Nonrecovery of kidney function and death after acute on chronic renal failure. Clin J Am Soc Nephrol. 2009;4:891–8.PubMedCrossRefPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Department of Nephrology and HypertensionHannover Medical SchoolHannoverGermany

Personalised recommendations