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Acute kidney injury

Defining prerenal azotemia in clinical practice and research

Prerenal azotemia is a common occurrence in hospitalized patients and is generally easier to define in clinical practice than in clinical research. Monitoring the duration of acute kidney injury and biomarkers of kidney function might help distinguish prerenal azotemia from acute tubular necrosis in both clinical practice and research settings.

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Figure 1: Classification systems for AKI.

References

  1. Uchino, S., Bellomo, R., Bagshaw, S. M. & Goldsmith, D. Transient azotaemia is associated with a high risk of death in hospitalized patients. Nephrol. Dial. Transplant. 25, 1833–1839 (2010).

    Article  Google Scholar 

  2. Thadhani, R., Pascual, M. & Bonventre, J. V. Acute renal failure. N. Engl. J. Med. 334, 1448–1460 (1996).

    CAS  Article  Google Scholar 

  3. Klahr, S. & Miller, S. B. Acute oliguria. N. Engl. J. Med. 338, 671–675 (1998).

    CAS  Article  Google Scholar 

  4. Bellomo, R. et al. 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 8, R205–R212 (2004).

    Article  Google Scholar 

  5. Mehta, R. L. et al. Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit. Care 11, R31 (2007).

    Article  Google Scholar 

  6. Bellomo, R., Bagshaw, S., Langenberg, C. & Ronco, C. Pre-renal azotemia: a flawed paradigm in critically ill septic patients? Contrib. Nephrol. 156, 1–9 (2007).

    PubMed  Google Scholar 

  7. Brown, J. B., Kramer, R. S., Coca, S. G. & Parikh, C. R. Duration of acute kidney injury impacts long-term survival following cardiac surgery. Ann. Thorac. Surg. (in press).

  8. Coca, S. G., King, J. T. Jr, Rosenthal, R. A., Perkal, M. F. & Parikh, C. R. The duration of postoperative acute kidney injury is an additional parameter predicting long-term survival in diabetic veterans. Kidney Int. doi: 10.1038/ki.2010.259.

  9. Coca, S. G., Yalavarthy, R., Concato, J. & Parikh, C. R. Biomarkers for the diagnosis and risk stratification of acute kidney injury: a systematic review. Kidney Int. 73, 1008–1016 (2008).

    CAS  Article  Google Scholar 

  10. Parikh, C. R., Lu, J. C., Coca, S. G. & Devarajan, P. Tubular proteinuria in acute kidney injury: a critical evaluation of current status and future promise. Ann. Clin. Biochem. 47, 301–312 (2010).

    CAS  Article  Google Scholar 

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Acknowledgements

C. R. Parikh was supported by NIH grants UO1- DK82185 and RO1-HL85757. S. G. Coca was supported by the career development grant K23DK08013 from the NIH.

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Correspondence to Chirag R. Parikh.

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Parikh, C., Coca, S. Defining prerenal azotemia in clinical practice and research. Nat Rev Nephrol 6, 641–642 (2010). https://doi.org/10.1038/nrneph.2010.128

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