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

John A Kellum, Norbert Lameire, KDIGO AKI Guideline Work Group, John A Kellum, Norbert Lameire, KDIGO AKI Guideline Work Group

Abstract

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.

Figures

Figure 1
Figure 1
Evaluation of acute kidney injury. AKI, acute kidney injury; GN, glomerulonephritis.
Figure 2
Figure 2
Stage-based management of acute kidney injury. Shading of boxes indicates priority of action: solid shading, actions that are equally appropriate at all stages; graded shading, increasing priority as intensity increases. AKI, acute kidney injury.

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