Acute Kidney Injury

  • Ian J. Stewart
  • Joseph J. DuBose
Chapter

Abstract

Acute kidney injury (AKI) is clinically diagnosed by evaluating relative changes in serum creatinine or decreases in urine output. AKI is common in critically ill surgical patients and can be a result of hypoperfusion, sepsis, rhabdomyolysis, abdominal compartment syndrome, or contrast-induced nephropathy. In addition to increasing the risk of multi-organ failure and in-hospital death, an episode of AKI is associated with poor long-term outcomes to include mortality, chronic kidney disease, and hypertension. While treatment of AKI is primarily supportive, renal replacement therapy can be initiated in severe cases.

Keywords

Acute kidney injury Intensive care unit Rhabdomyolysis Abdominal compartment syndrome Renal replacement therapy 

References

  1. 1.
    Bagshaw SM, George C, Dinu I, Bellomo R. A multi-centre evaluation of the RIFLE criteria for early acute kidney injury in critically ill patients. Nephrol Dial Transplant. 2008;23(4):1203–10. Available from: https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gfm744.CrossRefPubMedGoogle Scholar
  2. 2.
    Ostermann M, Chang R, Riyadh ICU Program Users Group T. Correlation between the AKI classification and outcome. Crit Care. 2008;12(6):R144. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19019254.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Ostermann M, Chang RWS. Acute kidney injury in the intensive care unit according to RIFLE. Crit Care Med. 2007;35(8):1837–43; quiz 1852. Available from: http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00003246-200708000-00004.CrossRefPubMedGoogle Scholar
  4. 4.
    Doi K, Ishizu T, Fujita T, Noiri E. Lung injury following acute kidney injury: kidney-lung crosstalk. Clin Exp Nephrol. 2011;15(4):464–70. Available from: http://link.springer.com/10.1007/s10157-011-0459-4.CrossRefPubMedGoogle Scholar
  5. 5.
    Clemens MS, Stewart IJ, Sosnov JA, et al. Reciprocal risk of acute kidney injury and acute respiratory distress syndrome in critically ill burn patients*. Crit Care Med. 2016;44(10):e915–22. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27340755.CrossRefPubMedGoogle Scholar
  6. 6.
    Lafrance J-P, Miller DR. Acute kidney injury associates with increased long-term mortality. J Am Soc Nephrol. 2010;21(2):345–52. Available from: http://www.jasn.org/cgi/doi/10.1681/ASN.2009060636.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Coca SG, Singanamala S, Parikh CR. Chronic kidney disease after acute kidney injury: a systematic review and meta-analysis. Kidney Int. 2012;81(5):442–8. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0085253815553234.CrossRefPubMedGoogle Scholar
  8. 8.
    Stewart IJ, Sosnov JA, Howard JT, et al. Retrospective analysis of long-term outcomes after combat injury: a hidden cost of war. Circulation. 2015;132(22):2126–33.CrossRefPubMedGoogle Scholar
  9. 9.
    Hsu C-Y, Hsu RK, Yang J, Ordonez JD, Zheng S, Go AS. Elevated BP after AKI. J Am Soc Nephrol. 2016;27(3):914–23. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26134154.CrossRefPubMedGoogle Scholar
  10. 10.
    Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P. Acute Dialysis Quality Initiative workgroup. Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care. 2004;8(4):R204–12. Available from: http://ccforum.biomedcentral.com/articles/10.1186/cc2872.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Mehta RL, Kellum JA, Shah SV, et al. Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care. 2007;11(2):R31. Available from: http://ccforum.biomedcentral.com/articles/10.1186/cc5713.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
  13. 13.
    Uchino S, Bellomo R, Goldsmith D, Bates S, Ronco C. An assessment of the RIFLE criteria for acute renal failure in hospitalized patients. Crit Care Med. 2006;34(7):1913–7. Available from: http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00003246-200607000-00008.CrossRefPubMedGoogle Scholar
  14. 14.
    Grams ME, Sang Y, Coresh J, et al. Acute kidney injury after major surgery: a retrospective analysis of veterans health administration data. Am J Kidney Dis. 2016;67(6):872–80. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26337133.CrossRefPubMedGoogle Scholar
  15. 15.
    Brusselaers N, Monstrey S, Colpaert K, Decruyenaere J, Blot SI, Hoste EAJ. Outcome of acute kidney injury in severe burns: a systematic review and meta-analysis. Intensive Care Med. 2010;36(6):915–25. Available from: http://link.springer.com/10.1007/s00134-010-1861-1.CrossRefPubMedGoogle Scholar
  16. 16.
    Coca SG, Bauling P, Schifftner T, Howard CS, Teitelbaum I, Parikh CR. Contribution of acute kidney injury toward morbidity and mortality in burns: a contemporary analysis. Am J Kidney Dis. 2007;49(4):517–23. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0272638606019196.CrossRefGoogle Scholar
  17. 17.
    Stewart IJ, Sosnov JA, Howard JT, Chung KK. Acute kidney injury in critically injured combat veterans: a retrospective cohort study. Am J Kidney Dis. 2016;68(4):564–70. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27155727.CrossRefPubMedGoogle Scholar
  18. 18.
    Bagshaw SM, George C, Gibney RTN, Bellomo R. A multi-center evaluation of early acute kidney injury in critically ill trauma patients. Ren Fail. 2008;30(6):581–9. Available from: http://www.tandfonline.com/doi/full/10.1080/08860220802134649%5Cnpapers3://publication/doi/10.1080/08860220802134649.CrossRefPubMedGoogle Scholar
  19. 19.
    Bihorac A, Delano MJ, Schold JD, et al. Incidence, clinical predictors, genomics, and outcome of acute kidney injury among trauma patients. Ann Surg. 2010;252(1):158–65. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3357629&tool=pmcentrez&rendertype=abstract.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Brown CVR, Rhee P, Chan L, Evans K, Demetriades D, Velmahos GC. Preventing renal failure in patients with rhabdomyolysis: do bicarbonate and mannitol make a difference? J Trauma. 2004;56(6):1191–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15211124.CrossRefPubMedGoogle Scholar
  21. 21.
    Stewart IJ, Faulk TI, Sosnov JA, et al. Rhabdomyolysis among critically ill combat casualties. J Trauma Acute Care Surg. 2016;80(3):492–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26670111.CrossRefPubMedGoogle Scholar
  22. 22.
    Shashaty MGS, Meyer NJ, Localio AR, et al. African American race, obesity, and blood product transfusion are risk factors for acute kidney injury in critically ill trauma patients. J Crit Care. 2012;27(5):496–504.  https://doi.org/10.1016/j.jcrc.2012.02.002.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Machado MN, Nakazone MA, Maia LN. Prognostic value of acute kidney injury after cardiac surgery according to kidney disease: improving global outcomes definition and staging (KDIGO) criteria. PLoS One. 2014;9(5):e98028. Available from: http://dx.plos.org/10.1371/journal.pone.0098028.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Chertow GM, Lazarus JM, Christiansen CL, et al. Preoperative renal risk stratification. Circulation. 1997;95(4):878–84. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9054745.CrossRefPubMedGoogle Scholar
  25. 25.
    Coleman MD, Shaefi S, Sladen RN. Preventing acute kidney injury after cardiac surgery. Curr Opin Anaesthesiol. 2011;24(1):70–6. Available from: http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00001503-201102000-00014.CrossRefPubMedGoogle Scholar
  26. 26.
    Nigwekar SU, Kandula P, Hix JK, Thakar CV. Off-pump coronary artery bypass surgery and acute kidney injury: a meta-analysis of randomized and observational studies. Am J Kidney Dis. 2009;54(3):413–23. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0272638609004417.CrossRefPubMedGoogle Scholar
  27. 27.
    Seabra VF, Alobaidi S, Balk EM, Poon AH, Jaber BL. Off-pump coronary artery bypass surgery and acute kidney injury: a meta-analysis of randomized controlled trials. Clin J Am Soc Nephrol. 2010;5(10):1734–44. Available from: http://cjasn.asnjournals.org/cgi/doi/10.2215/CJN.02800310.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Lamy A, Devereaux PJ, Prabhakaran D, et al. Off-pump or on-pump coronary-artery bypass grafting at 30 days. N Engl J Med. 2012;366(16):1489–97. Available from: http://www.nejm.org/doi/10.1056/NEJMoa1200388.CrossRefPubMedGoogle Scholar
  29. 29.
    Reents W, Hilker M, Börgermann J, et al. Acute kidney injury after on-pump or off-pump coronary artery bypass grafting in elderly patients. Ann Thorac Surg. 2014;98(1):9–15. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0003497514010388.CrossRefPubMedGoogle Scholar
  30. 30.
    Hobson CE, Yavas S, Segal MS, et al. Acute kidney injury is associated with increased long-term mortality after cardiothoracic surgery. Circulation. 2009;119(18):2444–53. Available from: http://circ.ahajournals.org/cgi/doi/10.1161/CIRCULATIONAHA.108.800011.CrossRefPubMedGoogle Scholar
  31. 31.
    Lameire N, Van Biesen W, Vanholder R. Acute renal failure. Lancet (Lond, Engl). 2005;365(9457):417–30. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0140673605178313.CrossRefGoogle Scholar
  32. 32.
    Mehta RL, Pascual MT, Soroko S, et al. Spectrum of acute renal failure in the intensive care unit: the PICARD experience. Kidney Int. 2004;66(4):1613–21. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0085253815502329.CrossRefPubMedGoogle Scholar
  33. 33.
    Bosch X, Poch E, Grau JM. Rhabdomyolysis and acute kidney injury. N Engl J Med. 2009;361(1):62–72. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19571284.CrossRefPubMedGoogle Scholar
  34. 34.
    Cervellin G, Comelli I, Lippi G. Rhabdomyolysis: historical background, clinical, diagnostic and therapeutic features. Clin Chem Lab Med. 2010;48(6):749–56. Available from: http://www.degruyter.com/view/j/cclm.2010.48.issue-6/cclm.2010.151/cclm.2010.151.xml.CrossRefPubMedGoogle Scholar
  35. 35.
    Brown CVR, Rhee P, Evans K, Demetriades D, Velmahos G. Rhabdomyolysis after penetrating trauma. Am Surg. 2004;70(10):890–2.PubMedGoogle Scholar
  36. 36.
    He Q, Wang F, Li G, et al. Crush syndrome and acute kidney injury in the Wenchuan Earthquake. J Trauma. 2011;70(5):1213–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21610435.CrossRefGoogle Scholar
  37. 37.
    El-Abdellati E, Eyselbergs M, Sirimsi H, et al. An observational study on rhabdomyolysis in the intensive care unit. Exploring its risk factors and main complication: acute kidney injury. Ann Intensive Care. 2013;3(1):8. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3614462&tool=pmcentrez&rendertype=abstract.CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    Melli G, Chaudhry V, Cornblath DR. Rhabdomyolysis: an evaluation of 475 hospitalized patients. Medicine (Baltimore). 2005;84(6):377–85. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16267412.CrossRefGoogle Scholar
  39. 39.
    de Meijer AR, Fikkers BG, de Keijzer MH, van Engelen BGM, Drenth JPH. Serum creatine kinase as predictor of clinical course in rhabdomyolysis: a 5-year intensive care survey. Intensive Care Med. 2003;29(7):1121–5. Available from: http://link.springer.com/10.1007/s00134-003-1800-5.CrossRefGoogle Scholar
  40. 40.
    Veenstra J, Smit WM, Krediet RT, Arisz L. Relationship between elevated creatine phosphokinase and the clinical spectrum of rhabdomyolysis. Nephrol Dial Transplant. 1994;9(6):637–41. Available from: http://www.ncbi.nlm.nih.gov/pubmed/7970089.CrossRefPubMedGoogle Scholar
  41. 41.
    Moore KP, Holt SG, Patel RP, et al. A causative role for redox cycling of myoglobin and its inhibition by alkalinization in the pathogenesis and treatment of rhabdomyolysis-induced renal failure. J Biol Chem. 1998;273(48):31731–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9822635.CrossRefPubMedGoogle Scholar
  42. 42.
    Heyman SN, Greenbaum R, Shina A, Rosen S, Brezis M. Myoglobinuric acute renal failure in the rat: a role for acidosis? Exp Nephrol. 1997;5(3):210–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9208280.PubMedGoogle Scholar
  43. 43.
    Zager RA, Foerder C, Bredl C. The influence of mannitol on myoglobinuric acute renal failure: functional, biochemical, and morphological assessments. J Am Soc Nephrol. 1991;2(4):848–55. Available from: http://www.ncbi.nlm.nih.gov/pubmed/1751788.PubMedGoogle Scholar
  44. 44.
    Sever MS, Vanholder R, RDRTF of ISN Work Group. Recommendations for the management of crush victims in mass disasters. Nephrol Dial Transplant. 2012;27(Suppl 1):i1. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22467763.CrossRefPubMedGoogle Scholar
  45. 45.
    Maerz L, Kaplan LJ. Abdominal compartment syndrome. Crit Care Med. 2008;36(4 Suppl):S212–5. Available from: http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00003246-200804001-00012.CrossRefPubMedPubMedCentralGoogle Scholar
  46. 46.
    Shaheen AW, Crandall ML, Nicolson NG, et al. Abdominal compartment syndrome in trauma patients: new insights for predicting outcomes. J Emerg Trauma Shock. 2016;9(2):53–7. Available from: http://www.onlinejets.org/text.asp?2016/9/2/53/179452.CrossRefPubMedPubMedCentralGoogle Scholar
  47. 47.
    Shear W, Rosner MH. Acute kidney dysfunction secondary to the abdominal compartment syndrome. J Nephrol. 2006;19(5):556–65. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17136682.PubMedGoogle Scholar
  48. 48.
    Muriithi AK, Leung N, Valeri AM, et al. Biopsy-proven acute interstitial nephritis, 1993–2011: a case series. Am J Kidney Dis. 2014;64(4):558–66. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0272638614008270.CrossRefPubMedGoogle Scholar
  49. 49.
    Praga M, González E. Acute interstitial nephritis. Kidney Int. 2010;77(11):956–61. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0085253815541768.CrossRefPubMedGoogle Scholar
  50. 50.
    Nolan CR, Anger MS, Kelleher SP. Eosinophiluria–a new method of detection and definition of the clinical spectrum. N Engl J Med. 1986;315(24):1516–9. Available from: http://www.nejm.org/doi/abs/10.1056/NEJM198612113152404.CrossRefPubMedGoogle Scholar
  51. 51.
    Muriithi AK, Nasr SH, Leung N. Utility of urine eosinophils in the diagnosis of acute interstitial nephritis. Clin J Am Soc Nephrol. 2013;8(11):1857–62. Available from: http://cjasn.asnjournals.org/cgi/doi/10.2215/CJN.01330213.CrossRefPubMedPubMedCentralGoogle Scholar
  52. 52.
    Clarkson MR, Giblin L, O’Connell FP, et al. Acute interstitial nephritis: clinical features and response to corticosteroid therapy. Nephrol Dial Transplant. 2004;19(11):2778–83. Available from: https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gfh485.CrossRefPubMedGoogle Scholar
  53. 53.
    González E, Gutiérrez E, Galeano C, et al. Early steroid treatment improves the recovery of renal function in patients with drug-induced acute interstitial nephritis. Kidney Int. 2008;73(8):940–6. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0085253815531050.CrossRefPubMedGoogle Scholar
  54. 54.
    Russo D, Minutolo R, Cianciaruso B, Memoli B, Conte G, De Nicola L. Early effects of contrast media on renal hemodynamics and tubular function in chronic renal failure. J Am Soc Nephrol. 1995;6(5):1451–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8589322.PubMedGoogle Scholar
  55. 55.
    Heinrich MC, Kuhlmann MK, Grgic A, Heckmann M, Kramann B, Uder M. Cytotoxic effects of ionic high-osmolar, nonionic monomeric, and nonionic iso-osmolar dimeric iodinated contrast media on renal tubular cells in vitro. Radiology. 2005;235(3):843–9. Available from: http://pubs.rsna.org/doi/10.1148/radiol.2353040726.CrossRefPubMedGoogle Scholar
  56. 56.
    Perazella MA, Coca SG, Hall IE, Iyanam U, Koraishy M, Parikh CR. Urine microscopy is associated with severity and worsening of acute kidney injury in hospitalized patients. Clin J Am Soc Nephrol. 2010;5(3):402–8. Available from: http://cjasn.asnjournals.org/cgi/doi/10.2215/CJN.06960909.CrossRefPubMedPubMedCentralGoogle Scholar
  57. 57.
    Espinel CH, Gregory AW. Differential diagnosis of acute renal failure. Clin Nephrol. 1980;13(2):73–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/7363517.PubMedGoogle Scholar
  58. 58.
    Diskin CJ, Stokes TJ, Dansby LM, Radcliff L, Carter TB. The comparative benefits of the fractional excretion of urea and sodium in various azotemic oliguric states. Nephron Clin Pract. 2010;114(2):c145–50. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19887835.CrossRefPubMedGoogle Scholar
  59. 59.
    Allon M, Copkney C. Albuterol and insulin for treatment of hyperkalemia in hemodialysis patients. Kidney Int. 1990;38(5):869–72. Available from: http://www.ncbi.nlm.nih.gov/pubmed/2266671.CrossRefPubMedGoogle Scholar
  60. 60.
    Sterns RH, Rojas M, Bernstein P, Chennupati S. Ion-exchange resins for the treatment of hyperkalemia: are they safe and effective? J Am Soc Nephrol. 2010;21(5):733–5. Available from: http://www.jasn.org/cgi/doi/10.1681/ASN.2010010079.CrossRefPubMedGoogle Scholar
  61. 61.
    Bushinsky DA, Williams GH, Pitt B, et al. Patiromer induces rapid and sustained potassium lowering in patients with chronic kidney disease and hyperkalemia. Kidney Int. 2015;88(6):1427–33. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0085253815610584.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Ian J. Stewart
    • 1
  • Joseph J. DuBose
    • 2
  1. 1.Combat Casualty Care Research, Clinical Investigation Facility, David Grant USAF Medical CenterTravis AFBUSA
  2. 2.Division of Vascular SurgeryDavid Grant Medical CenterTravis AFBUSA

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