Journal

JULY 2017 M L O – O N L I N E .C O M 38

FUTURE BUZZ ACU T E K IDNE Y INJURY

The importance of early detection in stopping
acute kidney injury
By Salvatore Di Somma, MD

A
cute kidney injury (AKI) is as serious and common as a
heart attack, and it can strike without any warning signs
or symptoms. It affects as many one in fi ve hospital pa-

tients in the United States1 and can rapidly develop into chronic
kidney disease (CKD) or kidney failure, leading in more severe
cases to the need for permanent dialysis treatment with com-
promised quality of life or even to death. Sometimes called a
silent killer, AKI is often overlooked as the true cause of mortal-
ity. AKI is also one of the costliest health issues both in the U.S.
and around the world.

Compounding the problem is that the medical community
has been slow to recognize the disease and implement a stan-
dard of care. However, recent developments and research have
led to new testing that can detect AKI much earlier than other
commonly used tests and is expected to improve clinical and
economic outcomes for patients and hospitals.

What is AKI?
AKI is the rapid deterioration of kidney function within hours
or days. It is often diagnosed in the context of other acute ill-
nesses.2 It indicates initial subclinical kidney cell injury that can
be reversible if the condition is detected early, before dysfunc-
tion. AKI is most commonly brought on by an infl ux of drugs
or toxins or contrast-induced substances, a blockage of urine,
serious infection, trauma, acute heart failure, major surgery,
or chronic illness. Up to 50 percent of critically ill patients will
develop some stage of AKI.3 Patients most at risk are those in
intensive care, as well as the elderly and diabetic patients.

AKI can cause the accumulation of waste products, electro-
lytes, and fl uid in the body as well as reduced immunity and
dysfunction of other organs.2 Prevention through proper test-
ing is the best measure to address AKI. Treatment of AKI can
include many different therapeutic strategies such as reducing
the intake of antibiotics or other drugs, managing fl uids and
diuretic dosages, and monitoring urine output. Other treat-
ments or surgeries could be delayed until the kidneys are
functioning normally. If detection of the risks of AKI occurs
early enough and changes to treatment are made, the kid-
neys can sometimes normalize themselves; consequently, it is
crucial to immediately recognize all phases of AKI occurrence.

More cases, more costs
While AKI is a preventable disease, it is a growing problem
around the world. A 2014 report by the National Confi den-
tial Enquiry into Patient Outcome and Death (NCEPOD), a
London-based nonprofi t that reviews the management of pa-
tients through research and surveys, found that 30 percent of
AKI cases that occurred during hospital admission