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Acute Kidney Injury: from Diagnosis to Treatment

Year 2026, Volume: 8 Issue: 1 , 63 - 65 , 31.03.2026
https://izlik.org/JA83CP94UX

Abstract

Acute kidney injury (AKI) is a clinical syndrome with high morbidity and mortality, characterized by a sudden and generally reversible deterioration in renal function developing over a short period. This review discusses the definition and staging of AKI according to the current KDIGO guidelines, its epidemiological characteristics including data from Turkey, and its broad spectrum of risk factors. The early recognition and emergency management of life-threatening electrocardiographic (ECG) changes, particularly those developing secondary to hyperkalemia, are emphasized. The primary objectives in the treatment approach include eliminating the underlying etiological cause, careful fluid management avoiding volume overload, and controlling complications such as hypertension. Renal replacement therapy modalities, namely intermittent hemodialysis (HD) and continuous renal replacement therapy (CRRT), which are applied in cases resistant to medical treatment or when definitive indications are present, are discussed in the context of the patient's clinical condition, hemodynamic stability, and intensive care settings.

References

  • Kuvvet Yoldaş T, Atalay A, Balcı C, Demirağ K, Uyar M, Çankayalı İ. Acute kidney injury in burns in the intensive care unit: A retrospective research. Ulus Travma Acil Cerrahi Derg. 2023;29(3):321-6. doi: 10.14744/tjtes.2022.95048. PubMed PMID: 36880617; PubMed Central PMCID: PMC10225834.
  • Chen B, Zhao J, Zhang Z, Li G, Jiang H, Huang Y, et al. Clinical characteristics and risk factors for severe burns complicated by early acute kidney injury. Burns. 2020;46(5):1100-6. Epub 20191213. doi: 10.1016/j.burns.2019.11.018. PubMed PMID: 31839503.
  • Ostermann M, Lumlertgul N, Jeong R, See E, Joannidis M, James M. Acute kidney injury. Lancet. 2025;405(10474):241-56. doi: 10.1016/s0140-6736(24)02385-7. PubMed PMID: 39826969.
  • Gursu M, Yegenaga I, Tuglular S, Dursun B, Bek SG, Bardak S, et al. Acute kidney injury in Turkey: epidemiological characteristics, etiology, clinical course, and prognosis. BMC Nephrol. 2022;23(1):326. Epub 20221005. doi: 10.1186/s12882-022-02933-1. PubMed PMID: 36199011; PubMed Central PMCID: PMC9533605.
  • Zhang X, Donnan PT, Bell S, Guthrie B. Non-steroidal anti-inflammatory drug induced acute kidney injury in the community dwelling general population and people with chronic kidney disease: systematic review and meta-analysis. BMC Nephrol. 2017;18(1):256. Epub 20170801. doi: 10.1186/s12882-017-0673-8. PubMed PMID: 28764659; PubMed Central PMCID: PMC5540416.
  • Gameiro J, Fonseca JA, Outerelo C, Lopes JA. Acute Kidney Injury: From Diagnosis to Prevention and Treatment Strategies. J Clin Med. 2020;9(6). Epub 20200602. doi: 10.3390/jcm9061704. PubMed PMID: 32498340; PubMed Central PMCID: PMC7357116.
  • Mattu A, Brady WJ, Robinson DA. Electrocardiographic manifestations of hyperkalemia. Am J Emerg Med. 2000;18(6):721-9. doi: 10.1053/ajem.2000.7344. PubMed PMID: 11043630.
  • Sparrow HG, Swan JT, Moore LW, Gaber AO, Suki WN. Disparate outcomes observed within Kidney Disease: Improving Global Outcomes (KDIGO) acute kidney injury stage 1. Kidney Int. 2019;95(4):905-13. Epub 20190226. doi: 10.1016/j.kint.2018.11.030. PubMed PMID: 30819553.
  • Yunos NM, Bellomo R, Hegarty C, Story D, Ho L, Bailey M. Association between a chloride-liberal vs chloride-restrictive intravenous fluid administration strategy and kidney injury in critically ill adults. Jama. 2012;308(15):1566-72. doi: 10.1001/jama.2012.13356. PubMed PMID: 23073953.
  • Chan MJ, Liu KD. Acute Kidney Injury and Subsequent Cardiovascular Disease: Epidemiology, Pathophysiology, and Treatment. Semin Nephrol. 2024;44(2):151515. Epub 20240606. doi: 10.1016/j.semnephrol.2024.151515. PubMed PMID: 38849258.
  • Kung CW, Chou YH. Acute kidney disease: an overview of the epidemiology, pathophysiology, and management. Kidney Res Clin Pract. 2023;42(6):686-99. Epub 20230511. doi: 10.23876/j.krcp.23.001. PubMed PMID: 37165615; PubMed Central PMCID: PMC10698062.
  • Sielski J, Kaziród-Wolski K, Piotrowska AM, Jurczak B, Klasa A, Kozieł K, et al. Contrast-Induced Nephropathy (CIN) After Invasive Treatment of Acute Coronary Syndromes—Predictors, Short and Long-Term Outcome. Journal of Clinical Medicine. 2025;14(11):3725. PubMed PMID: doi:10.3390/jcm14113725.
  • Bellomo R, Kellum JA, Ronco C. Acute kidney injury. Lancet. 2012;380(9843):756-66. Epub 20120521. doi: 10.1016/s0140-6736(11)61454-2. PubMed PMID: 22617274.
  • Rabindranath K, Adams J, Macleod AM, Muirhead N. Intermittent versus continuous renal replacement therapy for acute renal failure in adults. Cochrane Database Syst Rev. 2007(3):Cd003773. Epub 20070718. doi: 10.1002/14651858.CD003773.pub3. PubMed PMID: 17636735.

Akut Böbrek Hasarı: Tanıdan Tedaviye

Year 2026, Volume: 8 Issue: 1 , 63 - 65 , 31.03.2026
https://izlik.org/JA83CP94UX

Abstract

Akut böbrek hasarı (ABH), böbrek fonksiyonlarında kısa sürede gelişen ani ve genellikle geri dönüşümlü bozulma ile karakterize, morbidite ve mortalitesi yüksek klinik bir sendromdur. Bu derlemede, ABH'nin güncel KDIGO kılavuzlarına göre tanımı ve evrelemesi , Türkiye verilerini de içeren epidemiyolojik özellikleri ve geniş yelpazedeki risk faktörleri ele alınmaktadır. Özellikle hiperkalemiye bağlı gelişen, hayatı tehdit eden elektrokardiyografik (EKG) değişikliklerin erken tanınması ve acil müdahalesi vurgulanmıştır. Tedavi yaklaşımında altta yatan etiyolojik nedenin ortadan kaldırılması , aşırı yüklenmeden kaçınılarak yapılan dikkatli sıvı yönetimi ve hipertansiyon gibi komplikasyonların kontrolü temel hedeflerdir. Medikal tedaviye dirençli vakalarda veya kesin endikasyon varlığında uygulanan renal replasman tedavilerinde, aralıklı hemodiyaliz (HD) ve sürekli renal replasman tedavisi (CRRT) modaliteleri; hastanın klinik durumu, hemodinamik stabilitesi ve yoğun bakım koşulları bağlamında tartışılmıştır.

References

  • Kuvvet Yoldaş T, Atalay A, Balcı C, Demirağ K, Uyar M, Çankayalı İ. Acute kidney injury in burns in the intensive care unit: A retrospective research. Ulus Travma Acil Cerrahi Derg. 2023;29(3):321-6. doi: 10.14744/tjtes.2022.95048. PubMed PMID: 36880617; PubMed Central PMCID: PMC10225834.
  • Chen B, Zhao J, Zhang Z, Li G, Jiang H, Huang Y, et al. Clinical characteristics and risk factors for severe burns complicated by early acute kidney injury. Burns. 2020;46(5):1100-6. Epub 20191213. doi: 10.1016/j.burns.2019.11.018. PubMed PMID: 31839503.
  • Ostermann M, Lumlertgul N, Jeong R, See E, Joannidis M, James M. Acute kidney injury. Lancet. 2025;405(10474):241-56. doi: 10.1016/s0140-6736(24)02385-7. PubMed PMID: 39826969.
  • Gursu M, Yegenaga I, Tuglular S, Dursun B, Bek SG, Bardak S, et al. Acute kidney injury in Turkey: epidemiological characteristics, etiology, clinical course, and prognosis. BMC Nephrol. 2022;23(1):326. Epub 20221005. doi: 10.1186/s12882-022-02933-1. PubMed PMID: 36199011; PubMed Central PMCID: PMC9533605.
  • Zhang X, Donnan PT, Bell S, Guthrie B. Non-steroidal anti-inflammatory drug induced acute kidney injury in the community dwelling general population and people with chronic kidney disease: systematic review and meta-analysis. BMC Nephrol. 2017;18(1):256. Epub 20170801. doi: 10.1186/s12882-017-0673-8. PubMed PMID: 28764659; PubMed Central PMCID: PMC5540416.
  • Gameiro J, Fonseca JA, Outerelo C, Lopes JA. Acute Kidney Injury: From Diagnosis to Prevention and Treatment Strategies. J Clin Med. 2020;9(6). Epub 20200602. doi: 10.3390/jcm9061704. PubMed PMID: 32498340; PubMed Central PMCID: PMC7357116.
  • Mattu A, Brady WJ, Robinson DA. Electrocardiographic manifestations of hyperkalemia. Am J Emerg Med. 2000;18(6):721-9. doi: 10.1053/ajem.2000.7344. PubMed PMID: 11043630.
  • Sparrow HG, Swan JT, Moore LW, Gaber AO, Suki WN. Disparate outcomes observed within Kidney Disease: Improving Global Outcomes (KDIGO) acute kidney injury stage 1. Kidney Int. 2019;95(4):905-13. Epub 20190226. doi: 10.1016/j.kint.2018.11.030. PubMed PMID: 30819553.
  • Yunos NM, Bellomo R, Hegarty C, Story D, Ho L, Bailey M. Association between a chloride-liberal vs chloride-restrictive intravenous fluid administration strategy and kidney injury in critically ill adults. Jama. 2012;308(15):1566-72. doi: 10.1001/jama.2012.13356. PubMed PMID: 23073953.
  • Chan MJ, Liu KD. Acute Kidney Injury and Subsequent Cardiovascular Disease: Epidemiology, Pathophysiology, and Treatment. Semin Nephrol. 2024;44(2):151515. Epub 20240606. doi: 10.1016/j.semnephrol.2024.151515. PubMed PMID: 38849258.
  • Kung CW, Chou YH. Acute kidney disease: an overview of the epidemiology, pathophysiology, and management. Kidney Res Clin Pract. 2023;42(6):686-99. Epub 20230511. doi: 10.23876/j.krcp.23.001. PubMed PMID: 37165615; PubMed Central PMCID: PMC10698062.
  • Sielski J, Kaziród-Wolski K, Piotrowska AM, Jurczak B, Klasa A, Kozieł K, et al. Contrast-Induced Nephropathy (CIN) After Invasive Treatment of Acute Coronary Syndromes—Predictors, Short and Long-Term Outcome. Journal of Clinical Medicine. 2025;14(11):3725. PubMed PMID: doi:10.3390/jcm14113725.
  • Bellomo R, Kellum JA, Ronco C. Acute kidney injury. Lancet. 2012;380(9843):756-66. Epub 20120521. doi: 10.1016/s0140-6736(11)61454-2. PubMed PMID: 22617274.
  • Rabindranath K, Adams J, Macleod AM, Muirhead N. Intermittent versus continuous renal replacement therapy for acute renal failure in adults. Cochrane Database Syst Rev. 2007(3):Cd003773. Epub 20070718. doi: 10.1002/14651858.CD003773.pub3. PubMed PMID: 17636735.
There are 14 citations in total.

Details

Primary Language Turkish
Subjects Emergency Medicine
Journal Section Other
Authors

İsmail Buğra Bilen 0000-0002-9889-4561

Submission Date February 25, 2026
Acceptance Date March 9, 2026
Publication Date March 31, 2026
IZ https://izlik.org/JA83CP94UX
Published in Issue Year 2026 Volume: 8 Issue: 1

Cite

Vancouver 1.İsmail Buğra Bilen. Akut Böbrek Hasarı: Tanıdan Tedaviye. Phnx Med J. [Internet]. 2026 Mar. 1;8(1):63-5. Available from: https://izlik.org/JA83CP94UX

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