suggests that AKI-related mortality rates could be as high as 23.9% in adults and 13.8% in children.
There are a variety of steps that clinicians can take to manage AKI and stop it getting worse, including careful control of physiological fluid levels and avoiding drugs that might be toxic to the kidneys. The range of treatments for active AKI, however, is poor — renal replacement therapy, which typically involves dialysis, is currently the only option for limiting the damage.
There is also considerable effort going into developing better diagnostic and risk-assessment tools to detect AKI as quickly as possible and give clinicians the opportunity to step in earlier. Researchers have identified biomarkers that can be spotted sooner than the physiological indicators currently relied on to diagnose AKI. Existing markers can take days to become clear and therefore leave a narrow window to act before the damage worsens.
Researchers are also using known AKI risk factors, such as advanced age, smoking history, diabetes and cardiovascular disease to develop scoring systems as well as train machine-learning algorithms to predict who is in greatest jeopardy, and to allow caregivers to take steps to prevent AKI from occurring in the first place. Until better treatment options come along, such approaches might be the best hope for reducing the massive — and largely underappreciated — public-health toll of AKI.