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Paraskevi Pavlakou [1] and Vassilios Liakopoulos [2] and Theodoros Eleftheriadis [3] and Michael Mitsis [4] and Evangelia Dounousi [1]

Academic Editor: Rodrigo Franco

1, Department of Nephrology, Medical School University of Ioannina, Ioannina, Greece, uoi.gr

2, Division of nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece, auth.gr

3, Department of Nephrology, Medical School, University of Thessaly, Larissa, Greece, uth.gr

4, Department of Surgery, Medical School University of Ioannina, Ioannina, Greece, uoi.gr

Received May 15, 2017; Revised Aug 9, 2017; Accepted Aug 20, 2017

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

1. Introduction

Acute kidney injury (AKI) is a multifactorial clinical entity that presents with primary and secondary nonspecific manifestations due to a variety of causes (Table 1). Until the beginning of the 21st century, the incidence of AKI was not accurately reported due to the fact that AKI definition was highly dependent on clinician’s opinion and widely varied among different centers [1]. The definition and diagnosis of AKI based on standard criteria were first developed in 2004 by the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group which introduced the RIFLE (Risk, Injury, Failure, Loss, End-stage kidney disease) criteria [2] (Table 1). The different stages in RIFLE classification are delineated according to changes in serum creatinine levels and/or glomerular filtration rate (GFR) or urine output [2]. In 2007, the Acute Kidney Injury Network (AKIN) published a report that established AKI is the term to be used in order to describe the whole spectrum of acute kidney failure and proposed a modified RIFLE classification without including separately renal replacement therapy (RRT) [3]. Most recently, in 2012, Kidney Disease: Improving Global Outcomes (KDIGO) working group proposed that for accuracy purposes, serum creatinine measurements should be used instead of GFR estimation when staging AKI [4] and a guideline report was endorsed by the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF-KDOQI) as well [5] (Table 2).

Table 1

Common causes and susceptibilities for AKI.

Sepsis
Circulatory compromise (shock)
Burns/trauma
Cardiac surgery (especially with cardiopulmonary bypass)
Major (noncardiac) surgery
Nephrotoxic...

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