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Open Access 01-06-2017 | Review

Renal recovery after acute kidney injury

Authors: L. G. Forni, M. Darmon, M. Ostermann, H. M. Oudemans-van Straaten, V. Pettilä, J. R. Prowle, M. Schetz, M. Joannidis

Published in: Intensive Care Medicine | Issue 6/2017

Abstract

Acute kidney injury (AKI) is a frequent complication of critical illness and carries a significant risk of short- and long-term mortality, chronic kidney disease (CKD) and cardiovascular events. The degree of renal recovery from AKI may substantially affect these long-term endpoints. Therefore maximising recovery of renal function should be the goal of any AKI prevention and treatment strategy. Defining renal recovery is far from straightforward due in part to the limitations of the tests available to assess renal function. Here, we discuss common pitfalls in the evaluation of renal recovery and provide suggestions for improved assessment in the future. We review the epidemiology of renal recovery and of the association between AKI and the development of CKD. Finally, we stress the importance of post-discharge follow-up of AKI patients and make suggestions for its incorporation into clinical practice. Summary key points are that risk factors for non-recovery of AKI are age, CKD, comorbidity, higher severity of AKI and acute disease scores. Second, AKI and CKD are mutually related and seem to have a common denominator. Third, despite its limitations full recovery of AKI may best be defined as the absence of AKI criteria, and partial recovery as a fall in AKI stage. Fourth, after an episode of AKI, serial follow-up measurements of serum creatinine and proteinuria are warranted to diagnose renal impairment and prevent further progression. Measures to promote recovery are similar to those preventing renal harm. Specific interventions promoting repair are still experimental.

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Title: Renal recovery after acute kidney injury
Authors: L. G. Forni
M. Darmon
M. Ostermann
H. M. Oudemans-van Straaten
V. Pettilä
J. R. Prowle
M. Schetz
M. Joannidis
Publication date: 01-06-2017
Publisher: Springer Berlin Heidelberg
Published in: Intensive Care Medicine / Issue 6/2017
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-017-4809-x

ACC 2024 Congress

Springer Medicine

Renal recovery after acute kidney injury

Abstract

ACC 2024 Congress

Springer Medicine

Abstract

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