Epidemiology, Outcomes, and Diagnosis of Acute Kidney Injury

found that 4.9% of hospitalized patients developed AKI, defined as an increase in serum creatinine (SCr) of 0.5, 1.0, or 1.5 mg/dL depending on the baseline SCr. The major causes of hospital-acquired AKI were decreased renal perfusion (42%), major surgery (18%), contrast nephropathy (12%), and aminoglycoside antibiotics (7%). The crude in-hospital mortality rate was 25%, and rates increased in patients with increasing severity of AKI. This initial report of hospital-acquired AKI was updated almost 2 decades later. Nash et al 9 reported that 7.2% of patients developed AKI, higher than the 4.9% in the original study per- formed at a different institution, although the in-hospital mortality rate (19.4%) was slightly lower. The most common causes of AKI in the follow-up study were decreased renal perfusion (39%; defined broadly to include congestive heart failure (CHF), cardiac arrest, as well as volume contrac - tion), nephrotoxin administration ( 16%), contrast administration (11%), and major surgery (9%).