Raising awareness of acute kidney injury: a global perspective of a silent killer

Abstract

Worldwide, acute kidney injury (AKI) is associated with poor patient outcomes. Over the last few years, collaborative efforts, enabled by a common definition of AKI, have provided a description of the epidemiology, natural history, and outcomes of this disease and improved our understanding of the pathophysiology. There is increased recognition that AKI is encountered in multiple settings and in all age groups, and that its course and outcomes are influenced by the severity and duration of the event. The effect of AKI on an individual patient and the resulting societal burden that ensues from the long-term effects of the disease, including development of chronic kidney disease (CKD) and end-stage renal disease (ESRD), is attracting increasing scrutiny. There is evidence of marked variation in the management of AKI, which is, to a large extent, due to a lack of awareness and an absence of standards for prevention, early recognition, and intervention. These emerging data point to an urgent need for a global effort to highlight that AKI is preventable, its course is modifiable, and its treatment can improve outcomes. In this article, we provide a framework of reference and propose specific strategies to raise awareness of AKI globally, with the goal to ultimately improve outcomes from this devastating disease.

Figure 1

The global burden of AKI (Modified from (13)

Figure 2

FIGURE 2A: HIGH INCOME COUNTRIES FIGURE 2B: LOW AND MIDDLE INCOME COUNTRIES Figures 2A and 2B illustrate the burden of cases of AKI, deaths and progression to CKD in HI and LMI countries. In the latter, calculations were made assuming a similar incidence as in HI countries; actual data is unavailable. (Figures modified from (118)

Fig 3

Conceptual framework and targeted approach for raising awareness of AKI (modified from ref (119)