• Curr Opin Crit Care · Dec 2021

    Review

    Definitions of acute renal dysfunction: an evolving clinical and biomarker paradigm.

    • Marlies Ostermann, VinCent Wu, Dmitry Sokolov, and Nuttha Lumlertgul.
    • Department of Critical Care, King's College London, Guy's & St Thomas' NHS Foundation Trust, London, UK.
    • Curr Opin Crit Care. 2021 Dec 1; 27 (6): 553-559.

    Purpose Of ReviewThe current definition and classification of acute kidney injury (AKI) has limitations and shortcomings, which impact clinical management. The aim of this review is to highlight recent advances in our understanding of the pathophysiology and epidemiology of AKI, which impacts management and offers opportunities.Recent FindingsKidney damage varies according to the type of primary insult, secondary effects and mitigating responses and leads to distinct molecular, cellular and functional changes. Different sub-types of AKI with varying clinical phenotypes, recovery patterns and responses to therapeutic interventions have been identified. New tools to identify and characterize these AKI sub-types are available with the potential opportunity for individualized timely aetiology-based management of AKI.SummaryThe identification of different sub-phenotypes of AKI based on genetic, molecular, cellular and functional pathophysiological changes following potential nephrotoxic exposures is possible with new technologies. This offers opportunities for personalized management of AKI and supports the call for a refinement of the existing AKI criteria.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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