Acute kidney injury natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Farima Kahe M.D. [2]
Overview
If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
OR
Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
OR
Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
Natural History, Complications, and Prognosis
Natural History
- Certain forms of AKI such as contrast induced nephropathy, usually have a shorter course with creatinine peak in 3-5 days.[1]
Complications
- Common complications of acute kidney injury include:[2][3][4][5]
- Anemia
- Anorexia
- Nausea and vomiting
- Upper gastrointestinal bleeding
- Metabolic acidosis
- Hyperkalemia
- Pulmonary edema
- Hyperphosphatemia
- Risk of infectios disease
Prognosis
- Acute interstitial nephritis causing AKI can have a variable course, sometimes resolving with the withdrawal of the inciting agent and at times requiring several weeks to restore full renal function. Other forms related to a more severe systemic illness such as DIC, lupus, and RPGN often result in end-stage renal disease.[6]
- In general, the majority of patients that survive the initial insult recover their kidney function within 30 days.[6] Beyond two months, patients usually will not recover their full renal function but might have some improvement that allows them to be free of renal replacement therapy. [7][8]
- Despite the natural history showing possible recovery of renal function, AKI is associated with high mortality. AKI is also associated with increased length of hospital stay and costs.[1]
References
- ↑ 1.0 1.1 Chertow GM, Burdick E, Honour M, Bonventre JV, Bates DW (2005). "Acute kidney injury, mortality, length of stay, and costs in hospitalized patients". J Am Soc Nephrol. 16 (11): 3365–70. doi:10.1681/ASN.2004090740. PMID 16177006.
- ↑ Vandijck DM, Reynvoet E, Blot SI, Vandecasteele E, Hoste EA (2007). "Severe infection, sepsis and acute kidney injury". Acta Clin Belg. 62 Suppl 2: 332–6. PMID 18283994.
- ↑ Faubel S (July 2008). "Pulmonary complications after acute kidney injury". Adv Chronic Kidney Dis. 15 (3): 284–96. doi:10.1053/j.ackd.2008.04.008. PMID 18565479.
- ↑ White LE, Hassoun HT, Bihorac A, Moore LJ, Sailors RM, McKinley BA, Valdivia A, Moore FA (September 2013). "Acute kidney injury is surprisingly common and a powerful predictor of mortality in surgical sepsis". J Trauma Acute Care Surg. 75 (3): 432–8. doi:10.1097/TA.0b013e31829de6cd. PMC 3823059. PMID 24089113.
- ↑ Doyle JF, Forni LG (October 2015). "Long-Term Follow-up of Acute Kidney Injury". Crit Care Clin. 31 (4): 763–72. doi:10.1016/j.ccc.2015.06.017. PMID 26410143.
- ↑ 6.0 6.1 Kjellstrand CM, Gornick C, Davin T (1981). "Recovery from Acute Renal Failure". Renal Failure. 5 (1): 143–61. doi:10.3109/08860228109076011.
- ↑ Bagshaw SM (2006). "Epidemiology of renal recovery after acute renal failure". Curr Opin Crit Care. 12 (6): 544–50. doi:10.1097/01.ccx.0000247444.63758.0b. PMID 17077684.
- ↑ Ishani A, Xue JL, Himmelfarb J, Eggers PW, Kimmel PL, Molitoris BA; et al. (2009). "Acute kidney injury increases risk of ESRD among elderly". J Am Soc Nephrol. 20 (1): 223–8. doi:10.1681/ASN.2007080837. PMC 2615732. PMID 19020007.