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Diagnosis, evaluation, and management of acute kidney injury: a KDIGO summary (Part 1)

John A Kellum1*, Norbert Lameire2 and for the KDIGO AKI Guideline Work Group3

Author Affiliations

1 The Crisma Center, Department of Critical Care Medicine, 604 Scaife Hall, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA

2 Ghent University Hospital, De Pintelaan 185, Ghent B9000, Belgium

3 KDIGO AKI Guideline Work Group: John A Kellum (Work Group Co-Chair), University of Pittsburgh, PA, USA; Norbert Lameire (Work Group Co-Chair), University of Ghent, Belgium; Peter Aspelin, Karolinska Institute, Sweden; Rashad S Barsoum, Cairo University, Egypt; Emmanuel A Burdmann, University of São Paulo, Brazil; Stuart L Goldstein, Cincinnati Children's Hospital Medical Center, OH, USA; Charles A Herzog, Hennepin County Medical Center, MN, USA; Michael Joannidis, Medical University Innsbruck, Austria; Andreas Kribben, University of Duisburg-Essen, Germany; Andrew S Levey, Tufts University, MA, USA; Alison M Macleod, University of Aberdeen, UK; Ravindra L Mehta, University of California, San Diego, CA, USA; Patrick T Murray, University College Dublin, Ireland; Saraladevi Naicker, University of the Witwatersrand, South Africa; Steven M Opal, Brown University, RI, USA; Franz Schaefer, Heidelberg University Hospital, Germany; Miet Schetz, University of Leuven, Belgium; and Shigehiko Uchino, Jikei University School of Medicine, Japan

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Critical Care 2013, 17:204  doi:10.1186/cc11454

Published: 4 February 2013


Acute kidney injury (AKI) is a common and serious problem affecting millions and causing death and disability for many. In 2012, Kidney Disease: Improving Global Outcomes completed the first ever, international, multidisciplinary, clinical practice guideline for AKI. The guideline is based on evidence review and appraisal, and covers AKI definition, risk assessment, evaluation, prevention, and treatment. In this review we summarize key aspects of the guideline including definition and staging of AKI, as well as evaluation and nondialytic management. Contrast-induced AKI and management of renal replacement therapy will be addressed in a separate review. Treatment recommendations are based on systematic reviews of relevant trials. Appraisal of the quality of the evidence and the strength of recommendations followed the Grading of Recommendations Assessment, Development and Evaluation approach. Limitations of the evidence are discussed and a detailed rationale for each recommendation is provided.