Acute kidney injury-epidemiology, outcomes and economics.
Acute kidney injury (AKI) is a widespread problem of epidemic status. Compelling evidence indicates that the incidence of AKI is rapidly increasing, particularly among hospitalized patients with acute illness and those undergoing major surgery. This increase might be partially attributable to greater recognition of AKI, improved ascertainment in administrative data and greater sensitivity of consensus diagnostic and classification schemes. Other causes could be an ageing population, increasing incidences of cardiovascular disease, diabetes mellitus and chronic kidney disease (CKD), and an expanding characterization of modifiable risk factors, such as sepsis, administration of contrast media and exposure to nephrotoxins. The sequelae of AKI are severe and characterized by increased risk of short-term and long-term mortality, incident CKD and accelerated progression to end-stage renal disease. AKI-associated mortality is decreasing, but remains unacceptably high. Moreover, the absolute number of patients dying as a result of AKI is increasing as the incidence of the disorder increases, and few proven effective preventative or therapeutic interventions exist. Survivors of AKI, particularly those who remain on renal replacement therapy, often have reduced quality of life and consume substantially greater health-care resources than the general population as a result of longer hospitalizations, unplanned intensive care unit admissions and rehospitalizations.
Division of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Clinical Sciences Building, 2-124E, 8440-112 Street North West Edmonton, AB T6G 2B7, Canada.
Oleksa
O
Rewa
Division of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Clinical Sciences Building, 2-124E, 8440-112 Street North West Edmonton, AB T6G 2B7, Canada.
Sean M
SM
Bagshaw
D058186:Acute Kidney Injury / Q000150:complications / Q000191:economics* / Q000453:epidemiology* / Q000401:mortality; D000328:Adult; D000368:Aged; D002648:Child; D003404:Creatinine / Q000097:blood; D005440:Fluid Therapy / Q000009:adverse effects; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology; D008297:Male; D011788:Quality of Life; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000209:etiology; D018805:Sepsis / Q000150:complications; D014481:United States / Q000453:epidemiology
D003404:Creatinine