Rising incidence of acute kidney injury – The emerging significance of “pill” burden

Abstract

Acute kidney injury (AKI) is defined as a sudden fall in kidney function (over hours to days) resulting in accumulation of nitrogenous waste products and fluids in the body. It is at times a devastating syndrome with high costs to patients and health care systems.1 Most studies of AKI detection are based on serum creatinine levels with or without urine output measurements. The limitation of serum creatinine as a biomarker of AKI is well understood.2 The quest for novel biomarkers is on. These biomarkers should be able to segregate tissue injury from changes in function. This is one area in AKI where knowledge gap exists. The Risk, Injury, Failure, Loss of Function, End stage renal disease (RIFLE) criteria in 2004,3 Acute Kidney Injury Network (AKIN) criteria in 20074 and Kidney Disease Improving Global Outcomes (KDIGO) criteria in 20125 represent substantial advance in our efforts to standardize the definition of AKI.