Prediction of Acute Kidney Injury in the ICU

Acute Kidney Injury (AKI), is a clinicopathologic entity characterized by a sudden decrease in kidney function, leading to retention of metabolic waste products and the dysregulation of electrolyte homeostasis (1). Despite our progress in understanding the pathophysiology and a precise clinical definition and staging for diagnosis, AKI remains a global public health concern impacting approximately 13.3 million patients per year and resulting in 1.7 million deaths per year (2). Even though the economic burden of AKI is not well understood, AKI from hospitalization has been shown to be associated with an increase in hospitalization costs of $7933 and an increase in length of stay of 3.2 days. In addition, the corresponding results among patients hospitalized with AKI requiring dialysis were $42,077 and 11.5 days. AKI was associated with higher costs than myocardial infarction and comparable to those for stroke (3). Even if patients have survived, many go on to develop chronic kidney disease, end-stage renal disease, or exacerbate a pre-existing renal condition to accelerate toward ESRD, contributing to additional health care cost (4, 5). Furthermore, other than dialysis, no treatment reliably improves survival (6).