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Ichai C, Vinsonneau C, Souweine B, et al. Acute kidney injury in the perioperative period and in intensive care units (excluding renal replacement therapies). Ann Intensive Care. 2016;6(1):48doi: 10.1186/s13613-016-0145-5.
Ichai, C., Vinsonneau, C., Souweine, B., Armando, F., Canet, E., Clec'h, C., Constantin, J. M., Darmon, M., Duranteau, J., Gaillot, T., Garnier, A., Jacob, L., Joannes-Boyau, O., Juillard, L., Journois, D., Lautrette, A., Muller, L., Legrand, M., Lerolle, N., Rimmelé, T., Rondeau, E., Tamion, F., Walrave, Y., Velly, L. (2016). Acute kidney injury in the perioperative period and in intensive care units (excluding renal replacement therapies). Annals of intensive care, 6(1), 48. https://doi.org/10.1186/s13613-016-0145-5
Ichai, Carole, et al. "Acute kidney injury in the perioperative period and in intensive care units (excluding renal replacement therapies)." Annals of intensive care vol. 6,1 (2016): 48. doi: https://doi.org/10.1186/s13613-016-0145-5
Ichai C, Vinsonneau C, Souweine B, Armando F, Canet E, Clec'h C, Constantin JM, Darmon M, Duranteau J, Gaillot T, Garnier A, Jacob L, Joannes-Boyau O, Juillard L, Journois D, Lautrette A, Muller L, Legrand M, Lerolle N, Rimmelé T, Rondeau E, Tamion F, Walrave Y, Velly L. Acute kidney injury in the perioperative period and in intensive care units (excluding renal replacement therapies). Ann Intensive Care. 2016 Dec;6(1):48. doi: 10.1186/s13613-016-0145-5. Epub 2016 May 27. PMID: 27230984; PMCID: PMC4882312.
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Ann Intensive Care. 2016 Dec;6(1):48. doi: 10.1186/s13613-016-0145-5. Epub 2016 May 27.

Acute kidney injury in the perioperative period and in intensive care units (excluding renal replacement therapies).

Annals of intensive care

Carole Ichai, Christophe Vinsonneau, Bertrand Souweine, Fabien Armando, Emmanuel Canet, Christophe Clec'h, Jean-Michel Constantin, Michaël Darmon, Jacques Duranteau, Théophille Gaillot, Arnaud Garnier, Laurent Jacob, Olivier Joannes-Boyau, Laurent Juillard, Didier Journois, Alexandre Lautrette, Laurent Muller, Matthieu Legrand, Nicolas Lerolle, Thomas Rimmelé, Eric Rondeau, Fabienne Tamion, Yannick Walrave, Lionel Velly,

Affiliations

  1. Service de Réanimation Polyvalente, IRCAN (Inserm U1081, CNRS UMR7284 et CHU de Nice, Hôpital Pasteur 2, 30 Voie Romaine, CHU de Nice, 06000, Nice, France. [email protected].
  2. Service de Réanimation, Hôpital Marc Jacquet, 77000, Melun, France. [email protected].
  3. Service de Réanimation Polyvalente, CHU de Nice, 30 Voie Romaine, 06000, Nice, France.
  4. Service de Réanimation médicale, CHU de Clermont-Ferrand, 63000, Clermont-Ferrand, France.
  5. Service de Réanimation, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, 1 Avenue Claude Vellefaux, 75010, Paris, France.
  6. Service de Réanimation, Assistance Publique-Hôpitaux de Paris, Hôpital d'Avicenne, 125 rue de Stalingrad, 93000, Bobigny, France.
  7. Département de Médecine périopératoire, Hôpital Estaing, CHU de Clermont-Ferrand, 1 place Louis Aubrac, 63000, Clermont-Ferrand, France.
  8. Service de réanimation, hôpital de la Charité, CHU de Saint-Etienne, 44 rue Pointe Cadet, 42100, Saint-Etienne, France.
  9. Département d'anesthésie-réanimation, Assistance Publique-Hôpitaux de Paris, hôpital Kremlin-Bicêtre, 78, rue de la division du général Leclerc, 94270, Le Kremlin-Bicêtre, France.
  10. Service de Pédiatrie, hôpital Sud, CHU de Rennes, 16 Bd Bulgarie, 35203, Rennes, France.
  11. Service de Pédiatrie, Néphrologie, hôpital des Enfants, CHU de Toulouse, 330 avenue de Grande-Bretagne, 31059, Toulouse Cedex, France.
  12. Service d'anesthésie-réanimation, Assistance Publique-Hôpitaux de Paris, hôpital Saint-Louis, 1, Avenue Claude-Vellefaux, 75010, Paris, France.
  13. Service d'Anesthésie Réanimation II, Hôpital du Haut-Lévêque, CHU de Bordeaux, 33600, Pessac, France.
  14. Service de néphrologie-dialyse, hôpital Édouard-Herriot, Hospices Civils de Lyon, 5, Place d'Arsonval, 69003, Lyon, France.
  15. Service de réanimation, Assistance Publique-Hôpitaux de Paris, hôpital Européen Georges Pompidou, 20, rue Leblanc, 75908, Paris, France.
  16. Service de réanimation, hôpital Gabriel Montpied, CHU de Clermont-Ferrand, 58 rue Montalemberg, 63003, Clermont-Ferrand, France.
  17. Service de réanimation, hôpital Carémeau, CHU de Nîmes, 4 rue du Professeur Robert-Debré, 30029, Nîmes, France.
  18. Service d'anesthésie-réanimation, hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, 1, Avenue Claude-Vellefaux, 75010, Paris, France.
  19. Service de réanimation, centre hospitalier universitaire, CHU d'Angers, 4 rue Larrey, 49100, Angers, France.
  20. Service d'anesthésie réanimation, hôpital Édouard-Herriot, Hospices Civils de Lyon, 5, Place d'Arsonval, 69003, Lyon, France.
  21. Service de néphrologie, hôpital Tenon, Assistance Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020, Paris, France.
  22. Service de réanimation médicale, hôpital Charles-Nicolle, CHU de Rouen, 1 rue de Germont, 76031, Rouen, France.
  23. Service d'anesthésie-réanimation, hôpital de la Timone, Assistance Publique-Hôpitaux de Marseille, 13385, Marseille Cedex 5, France.

PMID: 27230984 PMCID: PMC4882312 DOI: 10.1186/s13613-016-0145-5

Abstract

Acute kidney injury (AKI) is a syndrome that has progressed a great deal over the last 20 years. The decrease in urine output and the increase in classical renal biomarkers, such as blood urea nitrogen and serum creatinine, have largely been used as surrogate markers for decreased glomerular filtration rate (GFR), which defines AKI. However, using such markers of GFR as criteria for diagnosing AKI has several limits including the difficult diagnosis of non-organic AKI, also called "functional renal insufficiency" or "pre-renal insufficiency". This situation is characterized by an oliguria and an increase in creatininemia as a consequence of a reduction in renal blood flow related to systemic haemodynamic abnormalities. In this situation, "renal insufficiency" seems rather inappropriate as kidney function is not impaired. On the contrary, the kidney delivers an appropriate response aiming to recover optimal systemic physiological haemodynamic conditions. Considering the kidney as insufficient is erroneous because this suggests that it does not work correctly, whereas the opposite is occurring, because the kidney is healthy even in a threatening situation. With current definitions of AKI, normalization of volaemia is needed before defining AKI in order to avoid this pitfall.

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