Acute Kidney Injury: Not Just Acute Renal Failure Anymore?
Susan Dirkes, RN, MSA, CCRN
Until recently, no uniform standard existed for diagnosing and classifying acute renal failure. To clarify diagnosis, the Acute Dialysis Quality Initiative group stated its consensus on the need for a clear definition and classification system of renal dysfunction with measurable criteria. Today the term acute kidney injury has replaced the term acute renal failure, with an understanding that such injury is a common clinical problem in critically ill patients and typically is predictive of an increase in morbidity and mortality. A classification system, known as RIFLE (risk of injury, injury, failure, loss of function, and end-stage renal failure), includes specific goals for preventing acute kidney injury: adequate hydration, maintenance of renal perfusion, limiting exposure to nephrotoxins, drug protective strategies, and the use of renal replacement therapies that reduce renal injury. (Critical Care Nurse. 2011;31:37-50)
he development of acute renal failure (ARF) continues to be a problem that markedly affects outcome in critically ill patients. Despite advances in treatment, development of ARF continues to be associated with high mortality rates, ranging from 40% to 90%.1,2 In addition, ARF is a major
This article has been designated for CE credit. A closed-book, multiple-choice examination follows this article, which tests your knowledge of the following objectives: 1. Define and discuss acute kidney injury (AKI) 2. Compare and contrast renal biomarkers for early detection of AKI 3. Understand the RIFLE classification system 4. Discuss prevention and treatment strategies for AKI ©2011 American Association of CriticalCare Nurses doi: 10.4037/ccn2011946
risk factor for nonrenal complications.3 Factors that may influence the high mortality rates include the increasing age of the population of patients and the existence...