Acute Kidney Injury: Global Health Alert

      Acute kidney injury (AKI) is increasingly prevalent in developing and developed countries and is associated with severe morbidity and mortality. Most etiologies of AKI can be prevented by interventions at the individual, community, regional and in-hospital levels. Effective measures must include community-wide efforts to increase an awareness of the devastating effects of AKI and provide guidance on preventive strategies, as well as early recognition and management. Efforts should be focused on minimizing causes of AKI, increasing awareness of the importance of serial measurements of serum creatinine in high risk patients, and documenting urine volume in acutely ill people to achieve early diagnosis; there is as yet no definitive role for alternative biomarkers. Protocols need to be developed to systematically manage prerenal conditions and specific infections. More accurate data about the true incidence and clinical impact of AKI will help to raise the importance of the disease in the community, increase awareness of AKI by governments, the public, general and family physicians and other health care professionals to help prevent the disease. Prevention is the key to avoid the heavy burden of mortality and morbidity associated with AKI.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Advances in Chronic Kidney Disease
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • KDIGO
        Clinical Practice Guideline for Acute Kidney Injury.
        Kidney Int. 2012; 2: 1-138
        • Ali T.
        • Khan I.
        • Simpson W.
        • et al.
        Incidence and outcomes in acute kidney injury: a comprehensive population-based study.
        J Am Soc Nephrol. 2007; 18: 1292-1298
        • Hsu C.Y.
        • McCulloch C.E.
        • Fan D.
        • et al.
        Community-based incidence of acute renal failure.
        Kidney Int. 2007; 72: 208-212
        • Fang Y.
        • Ding X.
        • Zhong Y.
        • et al.
        Acute kidney injury in a Chinese hospitalized population.
        Blood Purif. 2010; 30: 120-126
        • Lafrance J.P.
        • Miller D.R.
        Acute kidney injury associates with increased long-term mortality.
        J Am Soc Nephrol. 2010; 21: 345-352
        • Uchino S.
        • Kellum J.A.
        • Bellomo R.
        • et al.
        Acute renal failure in critically ill patients: a multinational, multicenter study.
        JAMA. 2005; 294: 813-818
        • Murugan R.
        • Kellum J.A.
        Acute kidney injury: what's the prognosis?.
        Nat Rev Nephrol. 2011; 7: 209-217
        • Coca S.G.
        • Singanamala S.
        • Parikh C.R.
        Chronic kidney disease after acute kidney injury: a systematic review and meta-analysis.
        Kidney Int. 2012; 81: 442-448
        • Santos W.J.
        • Zanetta D.M.
        • Pires A.C.
        • et al.
        Patients with ischaemic, mixed and nephrotoxic acute tubular necrosis in the intensive care unit - a homogeneous population?.
        Crit Care. 2006; 10: R68
        • Lombardi R.
        • Yu L.
        • Younes-Ibrahim M.
        • et al.
        Epidemiology of acute kidney injury in Latin America.
        Semin Nephrol. 2008; 28: 320-329
        • Naicker S.
        • Aboud O.
        • Gharbi M.B.
        Epidemiology of acute kidney injury in Africa.
        Semin Nephrol. 2008; 28: 348-353
        • Jha V.
        • Rathi M.
        Natural medicines causing acute kidney injury.
        Semin Nephrol. 2008; 28: 416-428
        • Abdulkader R.C.
        • Barbaro K.C.
        • Barros E.J.
        • et al.
        Nephrotoxicity of insect and spider venoms in Latin America.
        Semin Nephrol. 2008; 28: 373-382
        • Mehta R.L.
        • Kellum J.A.
        • Shah S.V.
        • et al.
        Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury.
        Crit Care. 2007; 11: R31
        • Cruz D.N.
        • Ricci Z.
        • Ronco C.
        Clinical review: RIFLE and AKIN–time for reappraisal.
        Crit Care. 2009; 13: 211
        • Bellomo R.
        • Kellum J.A.
        • Ronco C.
        Acute kidney injury.
        Lancet. 2012; 380: 756-766
        • Goldstein S.L.
        Acute kidney injury in children and its potential consequences in adulthood.
        Blood Purif. 2012; 33: 131-137
        • Chronopoulos A.
        • Cruz D.N.
        • Ronco C.
        Hospital-acquired acute kidney injury in the elderly.
        Nat Rev Nephrol. 2010; 6: 141-149
        • Waikar S.S.
        • Liu K.D.
        • Chertow G.M.
        Diagnosis, epidemiology and outcomes of acute kidney injury.
        Clin J Am Soc Nephrol. 2008; 3: 844-861
        • Cerda J.
        • Lameire N.
        • Eggers P.
        • et al.
        Epidemiology of acute kidney injury.
        Clin J Am Soc Nephrol. 2008; 3: 881-886
        • Perazella M.A.
        Drug use and nephrotoxicity in the intensive care unit.
        Kidney Int. 2012; 81: 1172-1178
        • Zarjou A.
        • Agarwal A.
        Sepsis and acute kidney injury.
        J Am Soc Nephrol. 2011; 22: 999-1006
        • Solomon R.
        • Dauerman H.L.
        Contrast-induced acute kidney injury.
        Circulation. 2010; 122: 2451-2455
        • MacLeod A.
        NCEPOD report on acute kidney injury- must do better.
        Lancet. 2009; 374: 1405-1406
        • Prescott A.M.
        • Lewington A.
        • O'Donoghue D.
        Acute kidney injury: top ten tips.
        Clin Med. 2012; 12: 328-332
        • Basu R.K.
        • Chawla L.S.
        • Wheeler D.S.
        • et al.
        Renal angina: an emerging paradigm to identify children at risk for acute kidney injury.
        Pediatr Nephrol. 2012; 27: 1067-1078
        • Mammen C.
        • Al Abbas A.
        • Skippen P.
        • et al.
        Long-term risk of CKD in children surviving episodes of acute kidney injury in the intensive care unit: a prospective cohort study.
        Am J Kidney Dis. 2012; 59: 523-530
        • Li P.K.
        • Chow K.M.
        • Matsuo S.
        • et al.
        Asian Chronic Kidney Disease (CKD) Best Practice Recommendations – Positional Statements for Early Detection of CKD from Asian Forum for CKD Initiatives (AFCKDI).
        Nephrology (Carlton). 2011; 16: 633-641
        • Fliser D.
        • Laville M.
        • Covic A.
        • et al.
        A European Renal Best Practice (ERBP) position statement on the Kidney Disease Improving Global Outcomes (KDIGO) Clinical Practice Guidelines on Acute Kidney Injury: Part 1: definitions, conservative management and contrast-induced nephropathy.
        Nephrol Dial Transplant. 2012; 27: 4263-4272
        • Cho A.
        • Lee J.E.
        • Yoon J.Y.
        • et al.
        Effect of an electronic alert on risk of contrast-induced acute kidney injury in hospitalized patients undergoing computed tomography.
        Am J Kidney Dis. 2012; 60: 74-81
        • Cox Z.L.
        • Nelsen C.L.
        • Waitman L.R.
        • et al.
        Effects of clinical decision support on initial dosing and monitoring of tobramycin and amikacin.
        Am J Health Syst Pharm. 2011; 68: 624-632
        • Colpaert K.
        • Hoste E.A.
        • Steurbaut K.
        • et al.
        Impact of real-time electronic alerting of acute kidney injury on therapeutic intervention and progression of RIFLE class.
        Crit Care Med. 2012; 40: 1164-1170
        • Andrade L.
        • de Francesco Daher E.
        • Seguro A.C.
        Leptospiral nephropathy.
        Semin Nephrol. 2008; 28: 383-394
        • Cerdá J.
        • Bagga A.
        • Kher V.
        • Chakravarthi R.M.
        The contrasting characteristics of acute kidney injury in developed and developing countries.
        Nat Clin Pract Nephrol. 2008; 4: 138-153
        • Ponce D.
        • Berbel M.N.
        • Regina de Goes C.
        • et al.
        High-volume peritoneal dialysis in acute kidney injury: indications and limitations.
        Clin J Am Soc Nephrol. 2012; 7: 887-894