STAGING PATIENTS WITH ACUTE KIDNEY INJURY: A NEW PARADIGN

摘要

Precise definitions for acute kidney injury (AKI) have not been established in veterinary medicine. A myriad of definitions have been proposed in both human medicine and veterinary medicine based on sequential changes in glomerular filtration rate (GFR), azotemia, or urine production to provide objective criteria for the diagnosis. To emphasize the concept that AKI represents a continuum of renal injury, staging schemes recently have been proposed for human patients to stratify the extent and duration of renal injury and to predict outcomes. One staging system is categorized progressively into Risk, Injury, Failure, Loss, and ESKD (RIFLE). A second slightly more restricted staging system emerged as an expert consensus from the Acute Kidney Injury Network (AKIN) in an attempt to reproducibly identify early AKI and classify its course and prognosis with regard appropriate diagnostic and therapeutic interventions. There is considerable overlap between both system, and criteria for each staging category are based ostensibly on insensitive markers of renal injury including abrupt changes in GFR, serum creatinine, urine output, and duration of signs.