Assessment and initial management of acute kidney injury

Acute kidney injury (AKI) is a common and dangerous complication of hospital admission; even mild degrees of dysfunction reduce the chances of survival. Unfortunately, as confirmed by the UK's National Confidential Enquiry into Patient Outcome and Death (NCEPOD), its recognition is often delayed and management frequently sub-optimal. A failure to recognize relevant risk factors may expose patients, unnecessarily, to the chance of developing AKI. In this review article, we present a structured approach to prevention, diagnosis and initial management that should provide a framework for routine clinical care.