Acute kidney injury (AKI) remains a challenging clinical problem for clinicians caring for critically-ill patients due largely to the paucity of specific therapeutic interventions aimed at mitigating poor outcome. Those patients most at risk for the development of AKI can often be identified by an assessment of demographic, clinical, diagnostic, and procedure-related factors couple with early and intensive bedside monitoring. Importantly, critically-ill patients are often exposed to multiple discrete risks that can accumulate during their course that can negatively impact not only the duration and severity of AKI, but also probability of recovery, and long-term functional decline and risk of development of chronic kidney disease. All critically-ill patients at risk of or with milder forms of AKI should have support individualized. A clear understanding of the scope, complexity, and general principals of prevention and management of AKI are indispensable in the care of these patients and will discussed in this chapter.
The nature and discriminatory value of urinary neutrophil gelatinase-associated lipocalin in critically ill patients at risk of acute kidney injury