Acute Kidney Injury for the Interventional Radiologist: A Review

Area of Science:

• Nephrology
• Radiology
• Critical Care Medicine

Background:

• Acute kidney injury (AKI) is prevalent in hospitalized patients, with higher incidence in critically ill individuals, those with chronic kidney disease (CKD), advanced age, or comorbidities.
• AKI significantly increases morbidity, mortality, and the risk of progression to CKD.
• Renal function relies on nephron activity for fluid balance, electrolyte homeostasis, and waste filtration; disruptions lead to AKI.

Purpose of the Study:

• To highlight the importance of understanding AKI for Vascular Interventional Radiology (VIR) consultations.
• To emphasize the need for distinguishing between contrast-associated AKI and contrast-induced AKI.
• To underscore the VIR's role in AKI prevention, diagnosis, and management.

Main Methods:

• Clinical evaluation involves history, physical examination, laboratory tests, urinalysis, and imaging.
• Diagnostic approaches aim to identify the underlying cause of AKI.
• Preventative strategies for AKI are crucial in patient management.

Main Results:

• AKI is associated with significant negative clinical impacts.
• Early recognition and management of AKI are essential.
• Understanding specific AKI types, like contrast-associated and contrast-induced, aids in procedural planning and post-procedural care.

Conclusions:

• The VIR plays a critical role in managing patients with or at risk of AKI.
• Distinguishing between different AKI etiologies, especially contrast-related, is vital for effective intervention.
• Improved understanding and strategies can mitigate the adverse effects of AKI.