title: Renal disease presenting as acute kidney injury: the diagnostic conundrum on the intensive care unit.
abstract: OBJECTIVE
  Acute kidney injury (AKI) is commonplace in most ICUs. In many cases the cause is believed to be multifactorial with sepsis being a major component. However, occasionally intrinsic renal disease will present to the ICU and as such critical care practitioners should be aware of this possibility and the ways in which such conditions may present.
  
  
  RESULTS
  Although a relatively rare occurrence the treatment for patients with intrinsic renal disease, particularly those who present as part of a vasculitic process, differs considerably from usual organ support employed on intensive care. Recent studies indicate that the outlook for these patients is poor particularly when the diagnosis is delayed. The use of serological investigations as well as other diagnostic techniques are discussed.
  
  
  CONCLUSIONS
  Not all AKI as described by changes in creatinine and urine output which presents or develops on the ICU is the same. AKI is a syndrome which encompasses many conditions and as such is nondiagnostic. Clinicians, when faced with AKI should satisfy themselves as to the likely cause of the AKI.
authors.affiliation: aDepartment of Renal Medicine, Royal Sussex County Hospital, Brighton, East Sussex bDepartment of Intensive Care Medicine, Surrey Peri-operative Anaesthesia Critical care collaborative Research group (SPACeR), Royal Surrey County Hospital, Guildford, UK.
authors.forename: Carolyn E
authors.initials: CE
authors.lastname: Amery
authors.forename: Lui G
authors.initials: LG
authors.lastname: Forni
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis*; D003937:Diagnosis, Differential; D006801:Humans; D007362:Intensive Care Units; D007674:Kidney Diseases / Q000175:diagnosis*