Acute renal failure

Czech version

Authors: J. Vachek; V. Tesař
Authors‘ workplace: Klinika nefrologie 1. LF UK a VFN v Praze
Published in: Kardiol Rev Int Med 2017, 19(4): 285-287

Overview

Acute and chronic renal failure are rather historical terms, which have been replaced by the precisely defined terms "acute kidney injury" and "chronic kidney disease". Acute kidney injury is generally defined as a sudden deterioration in renal function due to a decrease in glomerular filtration and is diagnosed based on accumulation of nitrogen metabolism end products, decreased urine output, or both. Chronic kidney disease lasts at least 3 months, with damage being defined either by the presence of structural changes, a pathological urinary finding or a significant reduction in glomerular filtration. If the last criterion is used, no further signs of kidney damage are required for diagnosis. In some cases, it is unclear whether acute kidney injury or chronic kidney disease are present. In such cases, medical history, searching for stigmata of organ damage and the development over time are important for a correct diagnosis. The aim of this paper is to give a brief overview of acute kidney damage, diagnostic options and therapeutic modalities.

Key words:
acute renal injury – chronic kidney disease – glomerular filtration

Sources

1. Mehta RL, Kellum JA, Shah SV et al. Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care 2007; 11(2): R31. doi: 10.1186/ cc5713.

2. Bellomo R, Ronco C, Kellum JA et al. Acute renal failure – definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care 2004; 8(4): R204– R212. doi: 10.1186/ cc2872.

3. Hsu CY, McCulloch CE, Fan D et al. Community-based incidence of acute renal failure. Kidney Int 2007; 72(2): 208– 212. doi: 10.1038/ sj.ki.5002297.

4. Levey AS, Eckardt KU, Tsukamoto Y et al. Definition and classification of chronic kidney disease: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int 2005; 67(6): 2089– 2100. doi: 10.1111/ j.1523-1755.2005.00365.x.

5. Prescott AM, Lewington A, O'Donoghue D. Acute kidney injury: top ten tips. Clin Med 2012; 12(4): 328– 332.

6. Druml W. Acute renal failure is not a "cute" renal failure! Intensive Care Med 2004; 30(10): 1886– 1890. doi: 10.1007/ s00134-004-2344-z.

7. Palevsky PM, Zhang JH, O'Connor TZ et al. Intensity of renal support in critically ill patients with acute kidney injury. N Engl J Med 2008; 359(1): 7– 20. doi: 10.1056/ NEJMoa0802639.

8. Bellomo R, Cass A, Cole L et al. Intensity of continuous renal-replacement therapy in critically ill patients. N Engl J Med 2009; 361(17): 1627– 1638. doi: 10.1056/ NEJMoa0902413.

9. Thakar CV, Christianson A, Himmelfarb J et al. Acute kidney injury episodes and chronic kidney disease risk in diabetes mellitus. Clin J Am Soc Nephrol 2011; 6(11): 2567– 2572. doi: 10.2215/ CJN.01120211.