Renal Injury

Abstract

Renal injury is a clinical syndrome characterised by progressive deterioration of renal function. In acute renal injury, the deterioration of kidney function occurs rapidly, over a period of days or weeks. It is often precipitated by a wide range of disorders affecting multiple organ systems. Conversely, renal dysfunction may develop gradually and is then termed chronic renal failure (CRF). Abrupt decline in renal function results in a potentially lethal condition if not promptly addressed. The disturbance in the internal milieu is manifested by azotaemia and multiple electrolyte imbalances. The development of CRF is far more insidious. The initial, barely noticeable, laboratory disarray will over time progress to major disturbances, warranting a variety of supportive treatments. Acute renal injury is a reversible event. Its resolution depends upon successful management of the underlying condition leading up to it. CRF, in contrast, is an irreversible condition. Whereas its exacerbations may be resolved upon recovery from the event that led to it, the underlying level of renal dysfunction will never recover. It should be mentioned that renal failure may at times be termed as subacute. It occurs gradually, over a period of several weeks, and results in high levels of azotaemia with a potentially poor outcome. The classification of renal injury into acute, subacute and chronic form is pivotal for the understanding and management of these pathologic entities.