Archives of General Internal Medicine

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Mini Review - Archives of General Internal Medicine (2023) Volume 7, Issue 4

Causes, Diagnosis, and Immediate Care for Acute Kidney Injury.

Sofia Walco*

Department of Anesthesiology, Vanderbilt University Medical Center, USA

*Corresponding Author:
Sofia Walco
Department of Anesthesiology
Vanderbilt University Medical Center
USA
E-mail: Walco556@gmail.com

Received:31 Jul-2023, Manuscript No. AAAGIM-23-109478; Editor assigned:05-Aug-2023, PreQC No. AAAGIM-23-109478 (PQ); Reviewed:18-Aug-2023, QC No. AAAGIM-23-109478; Revised:23-Aug-2023, Manuscript No. AAAGIM-23-109478 (R); Published:30-Aug-2023, DOI:10.35841/ aaaa-7.4.188

Citation: Walco S. Causes, Diagnosis, and Immediate Care for Acute Kidney Injury. Arch Gen Intern Med. 2023;7(3):188

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Introduction

Acute Kidney Injury (AKI) is a critical medical condition that requires immediate attention and prompt intervention. This sudden and rapid decline in kidney function can be caused by various factors and can have severe implications on a patient's overall health. As healthcare professionals, understanding the causes, diagnosing AKI early, and providing immediate care is of utmost importance to improve patient outcomes and prevent further complications. In this article, we will delve into the causes, diagnosis, and immediate care for Acute Kidney Injury, exploring the critical aspects of this condition and the steps necessary to address it effectively. We will explore the risk factors that can lead to AKI, the importance of early detection through accurate diagnosis, and the immediate care measures that healthcare providers can take to stabilize patients and prevent further kidney damage[1].

As we navigate through this essential topic, it is crucial to remember that AKI is a medical emergency that can affect patients of all ages and backgrounds. Timely recognition and appropriate management can significantly impact a patient's recovery and long-term kidney health. By staying informed and vigilant, healthcare professionals can make a significant difference in the lives of those at risk of or affected by Acute Kidney Injury. Let us now explore the intricacies of this condition and equip ourselves with the knowledge needed to tackle it effectively. Pre-renal AKI, acute post-renal obstructive nephropathy, and intrinsic acute kidney disorders are the three types of AKI. Only 'intrinsic' AKI indicates real kidney illness, whereas pre- and post-renal AKI are the result of extra-renal diseases that cause a drop in glomerular filtration rate (GFR). If these pre- and/or post-renal conditions persist, they will progress to renal cellular damage and, as a result, intrinsic renal disease[2].

The current AKI diagnostic method is predicated on an acute drop in GFR, as indicated by an increase in sCr levels and/or a decrease in UO during a certain time range. Several biomarkers have recently been proposed for the diagnosis of AKI, and they are now in various phases of development and validation. However, it is unclear if a single or multiple biomarker strategy is required to diagnose the intricate and multivariate characteristics of AKI. However, in addition to the analytical challenges connected with each unique biomarker, there is also a question about the suitable reference point, and more specifically, the use of sCr as the standard, for clinical evaluation of these biomarkers. It is well understood that sCr is unresponsive to acute changes in renal function, and that levels fluctuate greatly with age, gender, muscle mass, nutrition, medicines, and hydration status. Furthermore, it is a marker of GFR rather than a direct marker of tubular injury, and significant increases in sCr can be found in renal hypoperfusion even when the kidneys are structurally healthy, resulting in pre-renal azotaemia. For these reasons, sCr is regarded as a 'imperfect gold standard' for AKI diagnosis. Another concern with sCr is that its exact baseline value is not known in most clinical contexts, making patient evaluation difficult. Furthermore, given the phenotypic heterogeneity of AKI (various clinical manifestations with distinct underlying pathophysiologies), it is unclear whether different approaches to diagnosis, monitoring, and therapy are required[3].

The absence of a uniform definition of the illness had a significant impact on the reported incidence and clinical relevance of AKI, and its true impact is unknown. The incidence varies according to the definition employed, the patient population researched, and the geographical area studied. There are significant disparities in the incidence and aetiology of AKI between developing and developed countries. A recent review addressed the parallels and variations in AKI incidence, causation, pathogenesis, and public health consequences in industrialised and developing countries[4].

In developing countries' cities, the most prevalent causes of AKI are hospital acquired (renal ischaemia, sepsis, and nephrotoxic medications), whereas in rural regions, it is more commonly a result of community acquired disease (diarrhoea, dehydration, viral diseases, animal venoms, and so on). Under-reporting of AKI, particularly in developing nations, is another key issue that relates to the accurate understanding of its impact in many parts of the world[5].

Conclusion

AKI is a serious clinical illness that is linked to poor clinical outcomes in hospitalised patients. Significant progress has been achieved in clarifying the description of this condition and elucidating the underlying pathophysiologic mechanisms of the various clinical presentations. All clinical manifestations of AKI cannot be explained by a single pathophysiologic route. AKI promotes organ cross-talk and damage to distant organs. These advancements will benefit in the design of epidemiology research and randomised controlled trials of preventive and therapeutic therapies.

References

  1. Kellum JA, Romagnani P, Ashuntantang G, et al. Acute kidney injury. Nat Rev Dis Primers. 2021;7(1):52.

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  2. Darmon M, Ostermann M, Cerda J, et al. Diagnostic work-up and specific causes of acute kidney injury. Intensive Care Med. 2017;43:829-40.

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  3. Kellum JA, Lameire N. KDIGO AKI Guideline Work Group. Diagnosis, evaluation, and management of acute kidney injury: a KDIGO summary (Part 1). Critical care. 2013;17:1-5.

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  4. Russ KB, Stevens TM, Singal AK. Acute kidney injury in patients with cirrhosis. J Clin Transl Hepatol. 2015;3(3):195..

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  5. Fry AC, Farrington K. Management of acute renal failure. Postgrad Med J. 2006;82(964):106-16.

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