Acute kidney injury: definition controversies and epidemiology

The term acute kidney injury (AKI) has now replaced the older term ‘acute renal failure’. Clinically AKI is characterized by a rapid reduction in kidney function resulting in a failure to maintain fluid, electrolyte, and acid-base homoeostasis. However, the definitions in published works of AKI is non-homogenous, ranging from severe to relatively modest observable increases in serum creatinine concentration. Changes in serum creatinine levels are relatively insensitive to small changes in glomerular filtration rate. The varying incidence and prevalence of AKI may also be the result of different definition employed and methods used for ascertainment of cases. To date there is a paucity of data on the incidence of AKI. The incidence of AKI also varies with the clinical setting, community-acquired, hospital-acquired, sepsis-induced, and ICU-associated AKI. The recent review is an attempt to find out the evidences for recent changes in definition and epidemiology of AKI.