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Acute kidney injury (AKI), defined as an abrupt decrease in renal
function over a period of hours to days, is a common complication
among hospitalised patients with different acute diseases. Its
incidence has been increasing in recent years and is reported to be
very high especially in the acute settings. Since clinical signs
and symptoms of acute renal damage are not specific, it is
difficult to promptly distinguish AKI at the time of patient
presentation. Currently the diagnosis of AKI requires serial
assessment of laboratory tests over a period of several days, and
is based mainly on the evaluation of serum creatinine (sCr) and
decrease in urine output as supported by Risk, Injury, Failure,
Loss, and End-Stage Kidney Disease (RIFLE) criteria, Acute Kidney
Injury Network (AKIN) criteria, and the recent Kidney Disease:
Improving Global Outcomes (KDIGO) practice guidelines for AKI. Such
a need for repeated sCr evaluations and monitoring of urinary
output for too long time after admission could therefore result in
a diagnostic delay. With delays in diagnosis, clinicians miss
opportunities to start appropriate treatment to minimise damage,
and patients incur more severe AKI with subsequent greater risk of
developing progression of renal damage leading to chronic kidney
disease (CKD), dialysis and increased risk of severe cardiovascular
diseases and death.
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