Acute Kidney Injury Risk Assessment and the Nephrology Rapid Response Team

Abstract

Acute kidney Injury (AKI) is a serious medical condition affecting more than 10 million people around the world annually and resulting in poor outcomes. It has been suggested that late recognition of the syndrome may lead to delayed interventions with increased morbidity and mortality. Early diagnosis and timely therapeutic strategies may be the cornerstone of future improvement in outcomes. The purpose of this article is to provide a practical model to identify patients at high risk for AKI in different environments, with the goal to prevent AKI. We describe the AKI Risk Assessment (ARA) as a proposed algorithm that systematically evaluates the patient in high-risk situations of AKI in a simple way no matter where the patient is located, and allows different medical specialists to approach patients as a team with a nephrologist to improve outcomes. The goal of the nephrology rapid response team (NRRT) is to prevent AKI or start treatment if AKI is already diagnosed as a consequence of progressive events that can lead to progressive deterioration of kidney tissues and eventual decline in renal function and to ensure appropriate follow-up of patients at risk for progressive chronic kidney disease after the episode of AKI. Prevention is the key to avoid mortality and morbidity associated with AKI. Integration of these assessment tools in a global methodology that includes a multi-disciplinary team (NRRT) is critical to success. Video Journal Club 'Cappuccino with Claudio Ronco' at http://www.karger.com/?doi=452402.