Acute kidney injury in critical care: time for a paradigm shift?
OBJECTIVE
Acute alterations in renal function are commonly encountered in various settings with varied clinical manifestations ranging from a minimal elevation in serum creatinine to anuric renal failure. Our knowledge of human acute kidney injury has been fairly stagnant, until recently largely limited by a lack of concerted efforts in the field. This review summarizes the recent advances and provides an overview of emerging trends in this field.


RESULTS
One of the limitations in our knowledge of human acute kidney injury has been the lack of a standardized definition and staging criteria for this disorder. New information on the epidemiology and outcomes of acute kidney injury has emerged providing an opportunity to reappraise our approach to this disease. Also, there has been new work on the relationship of alterations of renal function to short and long-term outcomes, particularly mortality.


CONCLUSIONS
To translate advances from basic research to clinical application a multidisciplinary approach is required. New research in the field of biomarkers combined with clinical markers will lead to therapies that can be introduced earlier in the course of the disease and, hopefully, lead to a decrease in mortality from this potentially reversible condition.
Shah
Shamik H
SH
Department of Medicine, University of California San Diego, San Diego, California, USA. rmehta@ucsd.edu
Mehta
Ravindra L
RL
D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000453:epidemiology*; D015415:Biomarkers / Q000032:analysis; D003422:Critical Care; D006801:Humans
D015415:Biomarkers