Acute Kidney Injury: from Diagnosis to Treatment

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.

Keywords

• Acute kidney injury
• hyperkalemia
• renal replacement therapy
• electrocardiography
• emergency medicine

Akut Böbrek Hasarı: Tanıdan Tedaviye

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.

Keywords

• Akut böbrek hasarı
• hiperkalemi
• renal replasman tedavisi
• elektrokardiyografi
• acil tıp

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