HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) All Versions of this Article: CJN.05191107v1 3/3/844    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Waikar, S. S. Articles by Chertow, G. M. Search for Related Content PubMed PubMed Citation Articles by Waikar, S. S. Articles by Chertow, G. M.

Diagnosis, Epidemiology and Outcomes of Acute Kidney Injury

Sushrut S. Waikar^*, Kathleen D. Liu, and Glenn M. Chertow

^* Renal Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Division of Nephrology, Department of Medicine, University of California San Francisco, San Francisco, California, and Division of Nephrology, Department of Medicine, Stanford University, Stanford, California

Correspondence: Dr. Glenn M. Chertow, Stanford University School of Medicine, Grant Building, S-161, Stanford, CA 94305-5114. Phone: 650-725-4738; Fax: 650-723-7917; E-mail: gchertow{at}stanford.edu

Acute kidney injury is an increasingly common and potentially catastrophic complication in hospitalized patients. Early observational studies from the 1980s and 1990s established the general epidemiologic features of acute kidney injury: the incidence, prognostic significance, and predisposing medical and surgical conditions. Recent multicenter observational cohorts and administrative databases have enhanced our understanding of the overall disease burden of acute kidney injury and trends in its epidemiology. An increasing number of clinical studies focusing on specific types of acute kidney injury (e.g., in the setting of intravenous contrast, sepsis, and major surgery) have provided further details into this heterogeneous syndrome. Despite our sophisticated understanding of the epidemiology and pathobiology of acute kidney injury, current prevention strategies are inadequate and current treatment options outside of renal replacement therapy are nonexistent. This failure to innovate may be due in part to a diagnostic approach that has stagnated for decades and continues to rely on markers of glomerular filtration (blood urea nitrogen and creatinine) that are neither sensitive nor specific. There has been increasing interest in the identification and validation of novel biomarkers of acute kidney injury that may permit earlier and more accurate diagnosis. This review summarizes the major epidemiologic studies of acute kidney injury and efforts to modernize the approach to its diagnosis.

This article has been cited by other articles:

				R. J. Solomon, R. Mehran, M. K. Natarajan, S. Doucet, R. E. Katholi, C. S. Staniloae, S. K. Sharma, M. Labinaz, J. L. Gelormini, and B. J. Barrett Contrast-Induced Nephropathy and Long-Term Adverse Events: Cause and Effect? Clin. J. Am. Soc. Nephrol., July 1, 2009; 4(7): 1162 - 1169. [Abstract] [Full Text] [PDF]

				C.-y. Hsu, G. M. Chertow, C. E. McCulloch, D. Fan, J. D. Ordonez, and A. S. Go Nonrecovery of Kidney Function and Death after Acute on Chronic Renal Failure Clin. J. Am. Soc. Nephrol., May 1, 2009; 4(5): 891 - 898. [Abstract] [Full Text] [PDF]

				S. U. Nigwekar, S. D. Navaneethan, C. R. Parikh, and J. K. Hix Atrial Natriuretic Peptide for Management of Acute Kidney Injury: A Systematic Review and Meta-analysis Clin. J. Am. Soc. Nephrol., February 1, 2009; 4(2): 261 - 272. [Abstract] [Full Text] [PDF]

				J. V. Bonventre Dialysis in Acute Kidney Injury -- More Is Not Better N. Engl. J. Med., July 3, 2008; 359(1): 82 - 84. [Full Text] [PDF]