[Acute kidney injury - prevention and treatment]

Acute kidney injury is a heterogeneous multifactorial syndrome. Despite the existence of new biomarkers, changes in creatinine level or diuresis - both measures of kidney function - are still used to rate kidney injury. The kidney has several other functions, such as regulation of fluid balance, electrolyte balance, and hemodynamics. In addition, the kidney is endocrinologically active and secretes, among other things, renin and erythropoietin. All functions of the kidney can be impaired. Acute kidney injury is significantly associated with increased morbidity and mortality. Acute kidney injury often occurs secondarily to other diseases or organ failures. When encountering a patient with acute kidney injury in outpatient care, one must first assess whether life-threatening conditions such as hyperkalemia, severe metabolic acidosis, and fluid accumulation exist and, if so, promptly refer the patient to the emergency department. If there are no immediately life-threatening conditions, factors that can reverse kidney failure should be identified. If this is not successful, the patient should be referred to a nephrologist. Acute kidney injury in critically ill patients is often linked to other severe multi-organ failures. AKI should be carefully monitored and the kidneys should be protected as much as possible, and if kidney function deteriorates, renal replacement therapy should be initiated.