Abstract
Acute renal dysfunction is a common complication in hospitalized patients that is associated with significant morbidity and mortality. Patients with acute renal dysfunction often require admission to the intensive care unit, dialysis initiation, and prolonged hospitalization. While a combination of vascular, tubular, and inflammatory factors has been known to underlie most cases of acute kidney injury (AKI), several cohort studies have attempted to define risk factors for the development of AKI and to place cellular factors in the context of clinical presentations. Distinguishing prerenal AKI from intrinsic AKI is more difficult; however, it is important given the significant increase in morbidity and mortality in the latter. Prerenal causes of AKI include volume depletion from dehydration, blood loss, and diuretics. Causes of intrinsic renal failure commonly encountered on surgical service include ischemic and nephrotoxic acute tubular necrosis, contrast-induced nephropathy, and allergic interstitial nephritis. Renal replacement therapy is the definitive treatment for complications of AKI that are intractable to medical management.