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Uncommon Causes of Acute Kidney Injury
Cassandra L Formeck1, Carlos L Manrique-Caballero2, Hernando Gómez3
1Division of Nephrology, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, 4401 Penn Avenue, Faculty Pavilion, 4th Floor, Pittsburgh, PA 15224, USA; Center for Critical Care Nephrology, University of Pittsburgh, Pittsburgh, PA 15261, USA.
Critical Care Clinics
|April 4, 2022
Summary
Acute kidney injury (AKI) is a critical illness complication. Prompt diagnosis of uncommon AKI causes, including structural, immune-mediated, and microvascular issues, is vital for better patient outcomes.
Area of Science:
- Nephrology
- Critical Care Medicine
- Internal Medicine
Background:
- Acute kidney injury (AKI) is a frequent complication in critically ill patients, posing a significant public health challenge.
- Common AKI causes include sepsis, cardiac dysfunction, and nephrotoxic medications.
- However, rare causes of AKI can lead to severe patient outcomes if not diagnosed promptly.
Purpose of the Study:
- To highlight the importance of identifying uncommon causes of acute kidney injury (AKI).
- To categorize these less frequent AKI etiologies.
- To recommend diagnostic approaches for AKI in critically ill patients.
Main Methods:
- Review of literature on uncommon causes of AKI.
- Categorization of AKI causes into structural, immune-mediated, and microvascular.
- Emphasis on diagnostic tools such as kidney imaging, urine studies, and serum hemolytic studies.
Main Results:
- Uncommon AKI causes are classified into structural, immune-mediated, and microvascular categories.
- Thrombotic microangiopathies are a key example within the microvascular group.
- Early identification of these rare conditions is crucial.
Conclusions:
- Diagnostic workup for AKI in critical care should include evaluation for less common causes.
- Kidney imaging, urinalysis, and hemolytic markers are essential components of this evaluation.
- Timely diagnosis and management of rare AKI types can prevent severe patient outcomes.
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