Acute kidney injury: conceptual problems
Term «acute kidney injury» (AKI) replaced earlier term «acute kidney failure» (AKF). This replacement was determined by a number of reasons including an effort to unify criteria of diagnostics and stratification of severity of acute injury/kidney failure. Advantages and disadvantages of modern AKI classification systems were observed. However they indicate not only «injury» but also organ «failure». Among prospective approaches which provide optimization of classification there are discussed: stage separation (or AKI first stage addition) by transient revelation of AKI biomarkers, at stratification of severity of this state use not relative but absolute variations of serum creatinine concentration (Scr), refusal of criteria based on urinary volume change. AKI classification questions are important because this state is wide-spread, is still significant reason of formation and/or progression of chronic kidney disease, is considered to be important determinant of cardiovascular risk.