Updated approach to Acute Kidney Injury (AKI): a narrative review

Abstract

Objective: To clarify information about Acute Kidney Injury (AKI) and contribute to the medical literature. Bibliographic review: AKI is a rapid decline in renal function over days to weeks, resulting in the accumulation of nitrogenous products in the blood (azotemia), with or without a decrease in urine output. It is usually caused by hypoperfusion of the kidneys due to severe trauma, illness, or surgery, but in some cases it is caused by rapidly progressive intrinsic kidney disease. Symptoms can include anorexia, nausea and vomiting. If left untreated, seizures and coma can occur. Fluid, electrolyte and acid-base disturbances develop rapidly. Diagnosis is based on laboratory tests of renal function, including serum creatinine. Urine markers, urine sediment test, imaging tests, and others are needed to determine the cause. Treatment is specific to the cause but can also be accomplished by restoring fluid and electrolyte balance and sometimes dialysis. Final considerations: AKI has etiopathophysiology linked to the underlying disease of the patient and has always been a challenge for physicians due to the variety of its etiologies, clinical presentations and complications, and must be precisely identified for early management.