Acute Kidney Injury and Chronic Kidney Disease

Acute Kidney Injury (AKI) and Chronic Kidney Disease

Definition and Classification

• Acute Kidney Injury (AKI) is the hardening of renal arteries.
• RIFLE Classification describes the stages of AKI using a 5-tier system.
• RIFLE stands for Risk, Injury, Failure, Loss, and ESKD (End-Stage Kidney Disease).

Phases of AKI

• Initiation Phase: begins with the initial insult and ends when oliguria develops, accompanied by proteinuria or hypertension.
• Oliguria Phase: characterized by decreased urine output.
• Diuresis Phase: marked by increased urine output.
• Recovery Phase: the final stage of AKI, where the kidneys recover.

Chronic Kidney Disease (CKD)

• CKD is an umbrella term that describes kidney damage or a decrease in the glomerular filtration rate (GFR) lasting for 3 or more months.
• In the Philippines, CKD is the 4th leading cause of death among Filipinos.
• GFR is used to determine the stage of CKD, with the following stages:
  • Stage 1: GFR ≥ 90 mL/min/1.73 m2
  • Stage 2: GFR 60-89 mL/min/1.73 m2
  • Stage 3: GFR 30-59 mL/min/1.73 m2
  • Stage 4: GFR 15-29 mL/min/1.73 m2
  • Stage 5: GFR < 15 mL/min/1.73 m2, which is equivalent to End-Stage Kidney Disease (ESKD).

End-Stage Kidney Disease (ESKD)

• ESKD requires permanent renal replacement therapy.
• Progression to ESKD is faster in those with significant proteinuria or hypertension.

Acute Kidney Injury and Chronic Kidney Disease

Definitions

• Acute Kidney Injury (AKI): rapid loss of renal function due to kidney damage
• Chronic Kidney Disease (CKD): umbrella term for kidney damage or decreased glomerular filtration rate (GFR) lasting 3+ months
• End-Stage Kidney Disease (ESKD): GFR < 15 mL/min/1.73 m2, requiring permanent renal replacement therapy
• Uremia: syndrome where kidney function decline causes symptoms in multiple body systems

Phases of Acute Kidney Injury

• Initiation
• Oliguria
• Diuresis
• Recovery

Stages of Chronic Kidney Disease

• Stage 1: GFR ≥ 90 mL/min/1.73 m2
• Stage 2: GFR 60-89 mL/min/1.73 m2
• Stage 3: GFR 30-59 mL/min/1.73 m2
• Stage 4: GFR 15-29 mL/min/1.73 m2
• Stage 5: GFR < 15 mL/min/1.73 m2