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Acute Kidney Injury (AKI) is a rapid loss of kidney function. Its causes are numerous and include low blood volume, exposure to toxins, and sepsis with multi-organ failure. AKI is diagnosed on the basis of clinical history, such as decreased urine production, and characteristic laboratory findings, such as elevated blood urea nitrogen and creatinine.
Depending on its severity, AKI may lead to a number of complications, including metabolic acidosis, high potassium levels, changes in body fluid balance, and effects to other organ systems. Management includes supportive care, such as renal replacement therapy, as well as treatment of the underlying disorder.
Incidence and progression
Acute kidney injury occurs in 35-65% of ICU admissions and 5-20% of general hospital admissions. Mortality rates increase significantly with AKI, and most studies show a threefold to fivefold increase in the risk of death among patients with AKI compared to patients without AKI.
Treatment
AKI is most commonly treated with Continuous Renal Replacement Therapy (CRRT). CRRT is a general term referring to any extracorporeal blood purification therapy intended to substitute for impaired renal function over an extended period of time and aimed at being applied for 24 hours a day.
More and more clinicians are coming to agreement that CRRT is the modality of choice for treating ICU patients with AKI. In fact, an ever-expanding body of clinical evidence creates consensus that CRRT is the right therapy for 100% of hemodynamically unstable AKI patients.
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