Abstrakt

Acute kidney injury (AKI) is characterized by a rapid loss of kidney function combined with a reduced glomerular filtration rate and an increase of urinary excreted substances. Modern classification systems such as the RIFLE-criteria and the KDIGOclassification enable a clear definition and allocation of different kinds of cases of severity. The mortality risk and the necessity of kidney replacement therapy relate to the severity of AKI. In the last 25 years the incidence of AKI has increased, partly due to an increasing mean age of the patient population. Depending on the collective of patients examined, 3 – 90% are affected. Main causes of AKI in hospitalized patients are renal loss of perfusion (e.g. hypovolemic shock), external toxic damage (e.g. contrast media) and post-renal obstruction. Clinical symptoms vary from structural kidney damage without clinical symptoms to life-threatening complications due to hypervolemia and severe electrolyte imbalances. Chronic kidney disease, diabetes mellitus and congestive heart failure are important risk factors of AKI. Despite many breakthroughs in modern (intensive) healthcare including kidney replacement therapy, the mortality rate of patients with AKI who are in need of dialysis is still high. Thus the prevention and early detection of AKI is gaining field in clinical importance. Anamnesis and clinical examination are essential methods of diagnosis. Creatinine, urea and urine excretion are the main parameters in laboratory testing. Furthermore the ultrasound examinations of the kidneys are obligatory in diagnosing AKI. In cases of AKI without a determinable cause a kidney biopsy is indicated. Creatinine in serum and the production of urine should be examined frequently when AKI has been diagnosed for the first time and should be treated according to the KDOQI-CKD-guidelines. Presently there is no causal treatment of AKI. Thus the symptomatic therapy, treating the complications, is presently in focus. Mainly the closely monitoring of volumes and, in cases of conservative uncontrollable hyperpotassemia and fluid overload, the kidney replacement therapy are of importance.

Autoreninformation

Autoren

• H. Karakizlis
• P. Boide

Abteilungen

• Universitätsklinikum Giessen und Marburg, Standort Giessen, Medizinische Klinik II, SP Nephrologie

Adresse

Dr. med. Hristos Karakizlis
und
Dr. med Philipp Bolde
Universitätsklinikum Giessen und Marburg
Standort Giessen
Medizinische Klinik II, SP Nephrologie
Klinikstraße 33
D–35392 Giessen
Email: [email protected] und [email protected]

Citation