Acute kidney injury—epidemiology, outcomes and economics

Acute kidney injury (AKI) occurs in an estimated one in five adults and one in three children hospitalized with acute illness; the incidence of AKI is increasingSubclinical AKI, defined as elevation in levels of kidney damage biomarkers not fulfilling the conventional criteria for AKI, has characterized a subgroup of patients with increased risk of poor outcomeBedside clinical information systems can enable real-time automated electronic alerting for patients at risk of AKI or who develop early AKI; these systems can be integrated with evidence-based decision support toolsThe mortality associated with AKI remains unacceptably high, and increasing severity correlates with increasing mortality, the highest of which is among patients with overt kidney failure requiring renal replacement therapyReduced health-related quality of life and incident disability are increasingly recognized as important patient-centred outcomes following acute illness complicated by AKIAKI is now recognized as an important risk factor for nonrecovery of kidney function, incident chronic kidney disease, and accelerated progression to end-stage renal disease