Acute Renal Injury: Revisited

  • Kamel El-Reshaid Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait
  • Shaikha Al-Bader Nephrology center, Al-Amiri Hospital, Ministry of health, Kuwait


Acute kidney injury (AKI) indicates its abrupt deterioration and is defined as an increase in serum creatinine more than the baseline by > 26 umol/L within 48 hours or > 50% within 1 week.  The latter since glomerular failure is the life-threatening one with: (a) uremic intoxication, (b) water and salt retention with fluid overload, and (c) potassium accumulation with cardiac arrest.  The etiology can be pre-renal, post-renal or intrinsic.  Diagnosis is established by history of new insults, physical examination for hydration status, systemic stability and manifestations of autoimmune diseases/infections as well as an initial laboratory testing for renal function (serum creatinine, electrolytes and urine routine) and kidney ultrasound.  Additional specific tests are indicated to assess etiology of AKI and its associated co-morbid conditions that interacts with its management.  Severity of AKI ranges from mild (stage 1) to advanced (stage 5) that requires dialytic support.  Moreover, it depends on the type and duration of the insult.  Prognosis depends on etiology of AKI, its co-morbid conditions and the timely interventions by the supportive medical team. 

Keywords: acute, causes, epidemiology, injury, kidney, management.

Keywords: acute, causes, epidemiology, injury, kidney, management


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Author Biographies

Kamel El-Reshaid, Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait

Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait

Shaikha Al-Bader, Nephrology center, Al-Amiri Hospital, Ministry of health, Kuwait

Nephrology center, Al-Amiri Hospital, Ministry of health, Kuwait


1. Lote, Christopher J. (2012). Principles of Renal Physiology, 5th edition. Springer. p. 21.
2. Mukoyama M, Nakao K. Hormones of the kidney. In: Melmed S, Conn PM, editors. Endocrinology: Basic and clinical Principles. 2nd ed. Totowa, New Jersey: Humans Press; 2005. pp. 353–66.
3. Komlosi P, Fintha A, Bell PD. Current mechanisms of macula densa cell signalling. Acta Physiologica Scandinavica 2004; 181:463–469.
4. Guyton and Hall, Textbook of Medical Physiology, 13th Edition.
5. Rose GA. Measurment of glomerular filtration rate by inulin clearance without urine collection. BMJ 1969; 2:91-93.
6. Murray AW, Barnfield MC, Waller ML, Telford T, Peters AM. Assessment of Glomerular Filtration Rate Measurement with Plasma Sampling: A Technical Review. J Nucl Med Technol 2013; 41:67-75.
7. Ganong (2016). "Renal Function & Micturition". Review of Medical Physiology, 25th ed. McGraw-Hill Education. p. 677.
8. 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:R31.
9. El-Reshaid K, Kapoor M, Johny KV and Sugathan TN. Acute renal failure in Kuwait, a prospective study. J Trop Med Hygiene 1993; 96:323-329.
10. United States Renal Data System. 2018 USRDS annual data report: epidemiology of kidney disease in the United States. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2018.
11. Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO clinical practice guideline for acute kidney injury. Kidney Int 2012; 2(suppl):1-138.
12. John Francis Maher (1 January 1989). Replacement of renal function by dialysis: A text book of dialysis. Springer p: 33.
13. Ash SR, Bever SL. Peritoneal dialysis for acute renal failure: the safe, effective, and low-cost modality. Adv Ren Replace Ther 1995; 2:160-163.
14. Bellomo, Ronco C. Continuous hemofiltration in the intensive care unit. Crit Care 2000; 4:339-345.
15. Permuzic V, Basic-Jukic N, Jelakovic B, Kes P. Differences in CVVH vs. CVVHDF in the management of sepsis-induced acute renal injury in critically ill patients. J Artif Organs 2017; 20:326-334.
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How to Cite
El-Reshaid K, Al-Bader S. Acute Renal Injury: Revisited. JDDT [Internet]. 15Jul.2020 [cited 19May2022];10(4):221-4. Available from:

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