Renal recovery after acute kidney injury

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http://hdl.handle.net/10138/215219

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Forni , L G , Darmon , M , Ostermann , M , Oudemans-van Straaten , H M , Pettilä , V , Prowle , J R , Schetz , M & Joannidis , M 2017 , ' Renal recovery after acute kidney injury ' , Intensive Care Medicine , vol. 43 , no. 6 , pp. 855-866 . https://doi.org/10.1007/s00134-017-4809-x

Title: Renal recovery after acute kidney injury
Author: Forni, L. G.; Darmon, M.; Ostermann, M.; Oudemans-van Straaten, H. M.; Pettilä, Ville; Prowle, J. R.; Schetz, M.; Joannidis, M.
Contributor: University of Helsinki, Clinicum
Date: 2017-06
Language: eng
Number of pages: 12
Belongs to series: Intensive Care Medicine
ISSN: 0342-4642
URI: http://hdl.handle.net/10138/215219
Abstract: Acute kidney injury (AKI) is a frequent complication of critical illness and carries a significant risk of short-and long-term mortality, chronic kidney disease (CKD) and cardiovascular events. The degree of renal recovery from AKI may substantially affect these long-term endpoints. Therefore maximising recovery of renal function should be the goal of any AKI prevention and treatment strategy. Defining renal recovery is far from straightforward due in part to the limitations of the tests available to assess renal function. Here, we discuss common pitfalls in the evaluation of renal recovery and provide suggestions for improved assessment in the future. We review the epidemiology of renal recovery and of the association between AKI and the development of CKD. Finally, we stress the importance of post-discharge follow-up of AKI patients and make suggestions for its incorporation into clinical practice. Summary key points are that risk factors for non-recovery of AKI are age, CKD, comorbidity, higher severity of AKI and acute disease scores. Second, AKI and CKD are mutually related and seem to have a common denominator. Third, despite its limitations full recovery of AKI may best be defined as the absence of AKI criteria, and partial recovery as a fall in AKI stage. Fourth, after an episode of AKI, serial follow-up measurements of serum creatinine and proteinuria are warranted to diagnose renal impairment and prevent further progression. Measures to promote recovery are similar to those preventing renal harm. Specific interventions promoting repair are still experimental.
Subject: Acute kidney injury
Acute kidney disease
Chronic kidney disease
Renal replacement therapy
Follow-up
Biomarkers
CRITICALLY-ILL PATIENTS
GLOMERULAR-FILTRATION-RATE
LONG-TERM MORTALITY
REPLACEMENT THERAPY MODALITY
ISCHEMIA-REPERFUSION INJURY
RANDOMIZED CONTROLLED-TRIAL
INTENSIVE-CARE PATIENTS
CARDIAC-SURGERY
RISK-FACTOR
INTERMITTENT HEMODIALYSIS
3121 General medicine, internal medicine and other clinical medicine
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