Acute kidney injury: how do we define it?

Ann Clin Biochem 2010;47:4-7
© 2010 Association for Clinical Biochemistry


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Andrew J P Lewington and
Ahmed Sayed

Renal Department, St James’s University Hospital, Lincoln Wing, Beckett Street LS9 7TF, UK

Corresponding author: Andrew J P Lewington. Email: Andrew.Lewington{at}

Over recent years, there has been welcome increased interestin acute kidney injury (AKI) and its association with patientoutcome. The term AKI has replaced the term acute renal failure(ARF) and encompasses all types of ARF. New definitions andstaging systems for AKI have been proposed, which have stimulateda multitude of different studies to evaluate their clinicalutility. These recent advances need to be communicated to thewider health care community so that we are using a shared nomenclature.In 2009 the National Confidential Enquiry into Patient Outcomeand Death AKI study (‘Adding Insult to Injury’)announced its findings and recommendations. The report recommendedthat the detection of AKI and its management should be improved.These recommendations along with the adoption of the new stagingsystems will potentially have an impact on clinical biochemistrydepartments and exert an increased demand on resources. Runningin parallel with these initiatives is the quest to discovernovel biomarkers to detect AKI, the development and introductionof which will require laboratory support.

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