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Epidemiology of Acute Kidney Injury in the Intensive Care Unit

TLDR
The incidence of acute kidney injury in the intensive care unit (ICU) has increased during the past decade due to increased acuity as well as increased recognition, with lower incidence seen in elective surgical patients and higher incidence in sepsis patients.
Abstract
The incidence of acute kidney injury (AKI) in the intensive care unit (ICU) has increased during the past decade due to increased acuity as well as increased recognition. Early epidemiology studies were confounded by erratic definitions of AKI until recent consensus guidelines (RIFLE and AKIN) standardized its definition. This paper discusses the incidence of AKI in the ICU with focuses on specific patient populations. The overall incidence of AKI in ICU patients ranges from 20% to 50% with lower incidence seen in elective surgical patients and higher incidence in sepsis patients. The incidence of contrast-induced AKI is less (11.5%–19% of all admissions) than seen in the ICU population at large. AKI represents a significant risk factor for mortality and can be associated with mortality greater than 50%.

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Acute Kidney Injury: Definition, Pathophysiology and Clinical Phenotypes.

TL;DR: The view for AKI is beginning to change from a single organ failure syndrome to a syndrome where the kidney plays an active role in the progress of multi-organ dysfunction.
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Recent Advances in Models, Mechanisms, Biomarkers, and Interventions in Cisplatin-Induced Acute Kidney Injury.

TL;DR: A discussion of the foundation laid by cisplatin-induced AKI rodent models for the current understanding of AKI molecular pathophysiology is provided.
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Mechanisms and therapeutic targets of ischemic acute kidney injury.

TL;DR: Mechanisms of ischemic AKI-induced liver, intestine, and kidney dysfunction and systemic inflammation mainly mediated by Paneth cell degranulation as a potential explanation for the high mortality observed with AKI are proposed.
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Acute kidney injury in major abdominal surgery: incidence, risk factors, pathogenesis and outcomes.

TL;DR: A contemporary and critical review of AKI after major abdominal surgery focusing on its incidence, risk factors, pathogeny and outcomes is provided.
References
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Journal ArticleDOI

Early Goal-Directed Therapy in the Treatment of Severe Sepsis and Septic Shock

TL;DR: This study randomly assigned patients who arrived at an urban emergency department with severe sepsis or septic shock to receive either six hours of early goal-directed therapy or standard therapy (as a control) before admission to the intensive care unit.
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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.

TL;DR: A 2-day consensus conference on acute renal failure (ARF) in critically ill patients was organized by ADQI as discussed by the authors, where the authors sought to review the available evidence, make recommendations and delineate key questions for future studies.
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Acute Kidney Injury Network: Report of an Initiative to Improve Outcomes in Acute Kidney Injury

TL;DR: The Acute Kidney Injury Network (AKI Network) as discussed by the authors is a multidisciplinary collaborative network focused on AKI, which was established to improve care for patients with or at risk for AKI.
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