Clinical determinants of renal recovery

Acute kidney injury (AKI) is associated with increased mortality, prolonged hospitalization, and renal replacement therapy. Until recently, it was believed that the vast majority of patients recover from AKI without subsequent consequences. It is now recognized that patients with AKI may have very different renal outcomes, including complete recovery, incipient and progressive chronic kidney disease, and end-stage renal disease. Factors that influence these different outcomes have not been thoroughly evaluated and so are not currently understood. The patient's baseline demographic characteristics, subsequent clinical evolution, and factors associated with the treatment of these patients may all influence global and renal outcomes. Recovery from AKI is a potentially modifiable event and should be targeted for therapy. Useful tools are needed to monitor renal recovery and identify the patients at high risk for adverse outcomes.