Renal recovery following acute kidney injury : Current Opinion in Critical Care (original) (raw)
Renal system: Edited by Norbert Lameire
Division of Nephrology and Hypertension, Department of Medicine, University of California San Diego, San Diego, California, USA
Correspondence to Dr Ravindra L. Mehta, MD, DM, FACP, FASN, 200W Arbor Drive, Mail Code 8342, San Diego, CA 92103, USA Tel: +1 619 543 7310; fax: +1 619 543 7420; e-mail: [email protected]
Abstract
Purpose of review
Renal recovery after acute kidney injury (AKI) is an important outcome, most commonly defined as dialysis independence at hospital discharge. This review focuses on the epidemiology of renal recovery after AKI and provides a framework for determining the relationship of a lack of renal recovery and subsequent outcomes including the development of chronic kidney disease.
Recent findings
The majority of studies addressing renal recovery includes only critically ill patients requiring dialysis and considers renal recovery as dialysis independency at hospital discharge. However, a significant proportion of AKI patients are not in the ICU, are not dialyzed, and may require alternate definitions for assessing renal recovery. There is emerging evidence that an AKI episode can lead to chronic kidney disease and can accelerate the progression to end stage renal disease. Patients that survive after AKI present a higher long-term mortality risk, especially those with partial renal recovery.
Summary
Patients with incomplete renal recovery after AKI are underrepresented in most epidemiologic studies and the precise effect on the incidence and prevalence of end stage renal disease population has yet to be determined. A standardized definition for renal recovery is needed and the influence of an AKI episode on long-term outcomes needs to be better evaluated.
© 2008 Lippincott Williams & Wilkins, Inc.