Impact of acute kidney injury on chronic kidney disease and its progression.
ABSTRACT Acute kidney injury (AKI) is a devastating clinical problem that affects a growing number of patients, especially elderly ones, and is associated with high morbidity and mortality. It was previously thought that patients who survive an episode of AKI recover renal function without further sequelae; however, recent population- based studies suggest that this may not be the case. New clinical studies suggest that a strikingly large percentage of patients who have AKI do not fully recover renal function or require permanent renal replacement therapy, and that this population has an important impact on the epidemiology of chronic kidney disease (CKD) and end-stage renal disease. These clinical studies verify animal studies that have established a link between AKI and CKD progression. Future clinical studies are underway to prospectively characterize the natural history of AKI and CKD progression and to identify predictive biomarkers.
Article: Asian chronic kidney disease best practice recommendations: positional statements for early detection of chronic kidney disease from Asian Forum for Chronic Kidney Disease Initiatives (AFCKDI).[show abstract] [hide abstract]
ABSTRACT: 1. Targets: Patients with diabetes, hypertension Those with family history of chronic kidney disease Individuals receiving potentially nephrotoxic drugs, herbs or substances or taking indigenous medicine. Patients with past history of acute kidney injury Individuals older than 65 2. Tools: Spot urine sample for protein with standard urine Dipstick test (need a repeat confirmatory test if positive) Dipstick for red blood cells (need confirmation by urine microscopy) An estimate of glomerular filtration rate based on serum creatinine concentration 3. Frequency of Screening Screening frequency for targeted individuals should be yearly if no abnormality is detected on initial evaluation. 4. Who should perform the screening: Doctors, nurses, paramedical staff and other trained healthcare professionals 5. Intervention after screening Patients detected to have chronic kidney disease should be referred to primary care physicians with experience in management of kidney disease for follow up. A management protocol should be provided to the primary care physicians. Further referral to nephrologists for management will be based on the protocol together with clinical judgment of the primary care physicians with their assessment of the severity of chronic kidney disease and the likelihood of progression. 6. Screening for cardiovascular disease risk It is recommended that cardiovascular disease risk factors should be screened in all patients with CKD.Nephrology 07/2011; 16(7):633-41. · 1.31 Impact Factor