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Interventions for improving outcomes in acute kidney injury

Sarnowski, Alexander, Doyle, James F. and Forni, Lui G. (2019) Interventions for improving outcomes in acute kidney injury Current Opinion in Nephrology and Hypertension, 28 (6). pp. 567-572.

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Purpose of review Since the adoption of the classification of acute kidney injury (AKI) through changes in serum creatinine and/or urine output, much data have accumulated as to the associated risks in terms of morbidity and mortality after the development of AKI. However, until recently, a nihilistic approach persisted which implied that little could be done to alter the clinical course of a patient with AKI even where early identification was achieved. This view is reinforced by the opinion that given the broad cause underlying the syndrome of AKI, a ‘one size fits all’ approach is unlikely to be successful.

Recent findings Recent evidence suggests that the management of AKI may be improved somewhat by simple measures, such as the use of care bundles particularly in the intensive care setting. Moreover, there are other interventions using common treatments, which may prove to be of benefit as well as some early evidence that specific therapeutics may be on the horizon.

Summary Although a syndrome of significantly differing causes, the application of standardized care bundles appears promising and this approach may be improved by the use of specific therapies, including recombinant alkaline phosphatase, the use of intravenous bicarbonate and remote ischaemic preconditioning may also ameliorate the effects of AKI.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Biosciences and Medicine
Authors :
Sarnowski, Alexander
Doyle, James F.
Forni, Lui
Date : 2019
DOI : 10.1097/MNH.0000000000000552
Copyright Disclaimer : Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
Uncontrolled Keywords : Acute kidney injury; Alkaline phosphatase; Care bundles; Ischaemic preconditioning; Sodium bicarbonate
Depositing User : Clive Harris
Date Deposited : 31 Oct 2019 10:57
Last Modified : 31 Oct 2019 10:57

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