Andrew S. Levey, MD; Matthew T. James, MD
CME Objective: To review current evidence for screening, prevention, diagnosis, and treatment of acute kidney injury.
Funding Source: American College of Physicians.
Disclosures: Dr. Levey, ACP Contributing Author, reports that he was a member of the KDIGO Workgroup for the Clinical Practice Guideline on Acute Kidney Injury (published 2012). Dr. James, ACP Contributing Author, reports grants from Amgen Canada outside the submitted work. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-2010.
Acknowledgment: The authors thank Sara Couture, BS, and Bryan Ma for assistance with manuscript preparation.
With the assistance of additional physician writers, the editors of Annals of Internal Medicine develop In the Clinic using MKSAP and other resources of the American College of Physicians.
In the Clinic does not necessarily represent official ACP clinical policy. For ACP clinical guidelines, please go to https://www.acponline.org/clinical_information/guidelines/.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that she has no financial relationships or interests to disclose. Darren B. Taichman, MD, PhD, Executive Deputy Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Deborah Cotton, MD, MPH, Deputy Editor, reports that she has no financial relationships or interest to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Catharine B. Stack, PhD, MS, Deputy Editor for Statistics, reports that she has stock holdings in Pfizer and Johnson & Johnson.
Acute kidney injury is a heterogeneous group of conditions characterized by a sudden decrease in glomerular filtration rate, manifested by an increase in serum creatinine concentration or oliguria, and classified by stage and cause. This type of injury occurs in approximately 20% of hospitalized patients, with major complications including volume overload, electrolyte disorders, uremic complications, and drug toxicity. Management includes specific treatments according to the underlying cause and supportive treatment to prevent and manage complications. Kidney replacement therapy is used when complications cannot be managed with medical therapy alone. Despite advances in care, the mortality rate in patients requiring kidney replacement therapy remains approximately 50%.
Andrew S. Levey, Matthew T. James. Acute Kidney Injury. Ann Intern Med. 2017;167:ITC66–ITC80. doi: 10.7326/AITC201711070
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Published: Ann Intern Med. 2017;167(9):ITC66-ITC80.
Acute Kidney Injury, Nephrology.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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