Anest. intenziv. Med. 2011;22(1):19-22

Classification and diagnosis of kidney injury - are they still imperfect?Intesive Care Medicine - Review Article

Gerlichová Monika1,*, Živný Pavel2, Matějovič Martin3, Černý Vladimír1
1 Klinika anesteziologie, resuscitace a intenzivní medicíny, Univerzita Karlova v Praze, LF v Hradci Králové a Fakultní nemocnice Hradec Králové
2 Ústav klinické biochemie a diagnostiky, Univerzita Karlova v Praze, LF v Hradci Králové a Fakultní nemocnice Hradec Králové
3 I. interní klinika - JIP, Univerzita Karlova v Praze, LF v Plzni, Fakultní nemocnice Plzeň

Much is known about the causes and pathophysiology of kidney injury however many questions concerning its prevention, treatment and, above all, early diagnosis are yet to be answered. Several studies have shown that even small increases in serum creatinine levels have crucial effects on the course of the disease and prognosis in various patient populations. For this reason it is important to search for new preventive and early therapeutic measures which would protect the organism from the negative impact of renal dysfunction. Early diagnosis of acute kidney injury is crucial. For this reason research is currently focused on the detection of early markers in the plasma and urine which would indicate renal injury within hours. Untill the reliability of these markers is tested, the monitoring of diuresis, serum creatinine levels or the calculation of the glomerular filtration rate remain the standard procedures. In order to differentiate pre-renal injury from acute tubular necrosis, the importance of the urinary sediment examination is increasing. New RIFLE and AKIN classifications have made the definition of acute kidney injury more precise. They have also unified the previous classification schemes and made it possible to compare the results of different studies in a better way.

Keywords: acute kidney injury (AKI); serum creatinine; glomerular filtration rate (GFR); RIFLE and AKIN classification; early markers of renal dysfunction

Received: March 15, 2010; Accepted: November 8, 2010; Published: February 1, 2011  Show citation

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Gerlichová M, Živný P, Matějovič M, Černý V. Classification and diagnosis of kidney injury - are they still imperfect? Anest. intenziv. Med. 2011;22(1):19-22.
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