‘Acute kidney injury’ is modern terminology for a sudden decline in kidney function, and is defined by the RIFLE classification (RIFLE is an acronym for Risk, Injury, Failure, Loss and End-stage kidney disease).
Acute kidney injury occurs as a result of the combination of reduced perfusion in the kidney, systemic inflammation, and the administration of nephrotoxic drugs.
Patients with chronic renal damage, advanced age, diabetes mellitus or heart failure are at an increased risk of acute kidney injury.
In the short term, acute kidney injury leads to a markedly increased risk of death; the long-term effect of acute kidney injury is a permanent loss of renal microcirculation which could result in chronic renal disease.
Certain biomarkers in the urine offer new possibilities for detecting acute kidney injury in its early stage.
Treatment of patients with acute kidney injury is currently supportive in nature. The optimisation of a patient’s haemodynamics results in a reduction of the occurrence of acute kidney injury during extensive surgical procedures.
A promising treatment aimed at preventing acute kidney injury is called ‘remote ischaemic pre-conditioning’.
Conflict of interest and financial support: a disclosure form provided by the author is available along with the full text of this article at www.ntvg.nl; search for A5057, click on ‘Belangenverstrengeling’ (‘Conflict of interest’).