Acute kidney injury
Abstract
Acute kidney injury (AKI) is defined by a rapid increase in serum creatinine, decrease in urine output, or both. AKI occurs in approximately 10-15% of patients admitted to hospital, while its incidence in intensive care has been reported in more than 50% of patients. Kidney dysfunction or damage can occur over a longer period or follow AKI in a continuum with acute and chronic kidney disease. Biomarkers of kidney injury or stress are new tools for risk assessment and could possibly guide therapy. AKI is not a single disease but rather a loose collection of syndromes as diverse as sepsis, cardiorenal syndrome, and urinary tract obstruction. The approach to a patient with AKI depends on the clinical context and can also vary by resource availability. Although the effectiveness of several widely applied treatments is still controversial, evidence for several interventions, especially when used together, has increased over the past decade.
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Renal ischemia-reperfusion injury is one of the primary mechanisms underlying acute kidney injury.
“Renal ischemia-reperfusion (I/R) injury is one of the primary mechanisms underlying acute kidney injury (AKI)”
From Material-dependent oxygen transport governs ischemia-reperfusion injury and drug response in a kidney microphysiological system (2026) · cites this paper as Ronco et al., 2019
Cites
(2012) · Kidney International Supplements · doi:10.1038/kisup.2012.1 · Cited by 4,326 · see citing works
Self-citationA randomized trial of protocol-based care for early septic shock.
The ProCESS Investigators (2014) · New England Journal of Medicine · doi:10.1056/nejmoa1401602 · Cited by 2,414 · see citing works
Initiation strategies for renal-replacement therapy in the intensive care unit.
Gaudry, S., Hajage, D., Schortgen, F., Martin-Lefevre, L., Pons, B., Boulet, E., Boyer, A., Chevrel, G., Lerolle, N., Carpentier, D., et al. (2016) · New England Journal of Medicine · doi:10.1056/nejmoa1603017 · Cited by 1,243 · see citing works
Zarbock, A., Kellum, J. A., Schmidt, C., Van Aken, H., Wempe, C., Pavenstädt, H., Boanta, A., Gerß, J., & Meersch, M. (2016) · JAMA · doi:10.1001/jama.2016.5828 · Cited by 1,143 · see citing works
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Cao, J., Wang, B., Tang, T., Lv, L., Ding, Z., Li, Z., Hu, R., Wei, Q., Shen, A., Fu, Y., et al. (2020) · Stem Cell Research & Therapy · doi:10.1186/s13287-020-01719-2 · Cited by 264 · see citing works
Tan, J., Yin, K., Ouyang, Z., Wang, R., Pan, H., Wang, Z., Zhao, C., Guo, W., & Gu, X. (2021) · Analytical Chemistry · doi:10.1021/acs.analchem.1c03926 · Cited by 52 · see citing works
Kutsuzawa, N., Nakamura, H., Shinha, K., & Kimura, H. (2026) · Frontiers in Toxicology · doi:10.3389/ftox.2026.1854389
- Authors
- Ronco, C., Bellomo, R., & Kellum, J. A.
- Affiliations
- University of Padua (IT)
- Austin Hospital (AU)
- University of Pittsburgh (US)
- Corresponding author
- Ronco, Claudio
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2019-11
- Volume
- 394
- Issue
- 10212
- Pages
- 1949-1964
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W4211157472
- Cited by
- 1,910
- References
- 4
- Citations by year
- 2026: 272 · 2025: 365 · 2024: 341 · 2023: 317 · 2022: 278 · 2021: 224 · 2020: 110 · 2019: 1 · 2017: 1
- FWCI
- 23.85
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- Funders
- Astellas Pharma
- Topics
- Health Sciences › Medicine › Nephrology › Acute Kidney Injury Research
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Health Sciences › Medicine › Pathology and Forensic Medicine › Chemotherapy-induced organ toxicity mitigation
- Keywords
- acute kidney injury, serum creatinine, urine output, sepsis, cardiorenal syndrome, urinary tract obstruction, kidney injury biomarkers, risk assessment, AKI treatment, chronic kidney disease
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