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

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

Figures

Figure 1
Figure 1
Flow-chart summary of recommendations. Heparin includes low-molecular-weight heparin or unfractionated heparin. CRRT, continuous renal replacement therapy; RRT, renal replacement therapy.

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