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Related Concept Videos

Acute Kidney Injury I: Introduction01:22

Acute Kidney Injury I: Introduction

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Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
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Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

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Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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Acute Kidney Injury II: Pathophysiology01:29

Acute Kidney Injury II: Pathophysiology

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Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
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Acute Kidney Injury III: Clinical Manifestations01:29

Acute Kidney Injury III: Clinical Manifestations

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Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
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Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

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Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
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Acute Kidney Injury VI: Nursing Management01:22

Acute Kidney Injury VI: Nursing Management

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Acute Kidney Injury (AKI) results in an inability to maintain fluid, electrolyte, and acid-base balance. Effective nursing management is critical in improving patient outcomes and includes comprehensive patient assessment and targeted interventions.Comprehensive Patient AssessmentA detailed history collection is essential, focusing on any recent infections, nephrotoxic medication use, or chronic conditions such as hypertension and diabetes that may contribute to AKI. During the physical...
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Related Experiment Video

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Standardized Colon Ascendens Stent Peritonitis in Rats - a Simple, Feasible Animal Model to Induce Septic Acute Kidney Injury
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De Ritis Ratio Trajectories and Mortality Risk in Sepsis-Associated Acute Kidney Injury.

Xiaobin Luo1, Guoliang Huang1, Weilian Zeng1

  • 1Emergency Department, Jieyang People's Hospital, Jieyang, China.

The Journal of Surgical Research
|March 20, 2026
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Summary

Persistently high De Ritis ratio in sepsis-associated acute kidney injury (SA-AKI) patients indicates a higher risk of death. Tracking these levels in the ICU can predict mortality outcomes.

Keywords:
De Ritis ratioMortalitySepsis-associated acute kidney injuryTrajectory

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Area of Science:

  • Critical Care Medicine
  • Nephrology
  • Biomarkers

Background:

  • Sepsis-associated acute kidney injury (SA-AKI) is a frequent and severe complication in critically ill patients.
  • The De Ritis ratio's prognostic significance in SA-AKI requires further investigation.

Purpose of the Study:

  • To identify distinct longitudinal trajectories of the De Ritis ratio in SA-AKI patients.
  • To assess the prognostic value of these trajectories for mortality.

Main Methods:

  • Retrospective cohort study using the MIMIC database (4468 SA-AKI patients).
  • Group-based trajectory modeling to define De Ritis ratio patterns.
  • Cox proportional hazards models to analyze mortality risks.

Main Results:

  • Three De Ritis ratio trajectories were identified: persistently low, moderate, and high.
  • Persistently high and moderate trajectories were significantly associated with increased ICU and 30-day mortality.
  • Associations were stronger in emergency department admissions.

Conclusions:

  • Persistently elevated De Ritis ratio trajectories within 7 days of ICU admission are independent predictors of mortality in SA-AKI.
  • The De Ritis ratio's dynamic changes offer valuable prognostic information for SA-AKI management.