Diagnosis, evaluation, and management of acute kidney injury : a KDIGO summary (part 1)

Acute kidney injury (AKI) is a common and serious problem affecting millions and causing death and disability for many. In 2012, Kidney Disease: Improving Global Outcomes completed the first ever, international, multidisciplinary, clinical practice guideline for AKI. The guideline is based on evidence review and appraisal, and covers AKI definition, risk assessment, evaluation, prevention, and treatment. In this review we summarize key aspects of the guideline including definition and staging of AKI, as well as evaluation and nondialytic management. Contrast-induced AKI and management of renal replacement therapy will be addressed in a separate review. Treatment recommendations are based on systematic reviews of relevant trials. Appraisal of the quality of the evidence and the strength of recommendations followed the Grading of Recommendations Assessment, Development and Evaluation approach. Limitations of the evidence are discussed and a detailed rationale for each recommendation is provided

Contrast-induced acute kidney injury and renal support for acute kidney injury : a KDIGO summary (part 2)

Acute kidney injury (AKI) is a common and serious problem affecting millions and causing death and disability for many. In 2012, Kidney Disease: Improving Global Outcomes completed the first ever international multidisciplinary clinical practice guideline for AKI. The guideline is based on evidence review and appraisal, and covers AKI definition, risk assessment, evaluation, prevention, and treatment. Two topics, contrast-induced AKI and management of renal replacement therapy, deserve special attention because of the frequency in which they are encountered and the availability of evidence. Recommendations are based on systematic reviews of relevant trials. Appraisal of the quality of the evidence and the strength of recommendations followed the Grading of Recommendations Assessment, Development and Evaluation approach. Limitations of the evidence are discussed and a detailed rationale for each recommendation is provided. This review is an abridged version of the guideline and provides additional rationale and commentary for those recommendation statements that most directly impact the practice of critical care

Controversies in acute kidney injury: the 2011 Brussels Roundtable

The recent advent of consensus definitions for acute kidney injury (AKI) has led to improvement in epidemiology of this complex disease and facilitated the development of new diagnostic makers and new therapies. However, important new challenges are also apparent. We still do not really understand why AKI occurs and urgently need to develop new therapies to treat it. Progress in this area will require new ideas and thinking outside the conventional box. By confronting some of the most significant controversies in the field of AKI we seek to develop new concepts that will ultimately yield new results

Understanding genetics of sepsis: will new technology help?

High-throughput techniques, such as genome-wide scans, will allow genotyping of a large number of single-nucleotide polymorphisms throughout the human genome. There is intense interest to apply this technology to understand genetics of complex traits, including severe sepsis. To effectively utilize this technology, large cohorts of septic patients will have to be recruited. Careful attention should be paid to different aspects of study design and analyses as large, multicenter cohorts are assembled for genome-wide association studies