Die Grenzen verschwimmen schnell, wenn es um die ANV-Klassifikation geht, insbesondere
zwischen prärenalen und renalen Ursachen. Es besteht ein enger Zusammenhang zwischen
Mortalität und chronischer Nierenerkrankung. Aufgrund der hohen Inzidenz sollte ein
ANV von klinisch tätigen Ärzten unmittelbar erkannt und ätiologisch eingeordnet werden
können. Dieser Beitrag soll einen Überblick über die häufigsten Gründe eines ANV geben.
Abstract
Acute kidney injury (AKI) refers to an acute functional deterioration of the kidneys,
which leads to retention of urinary substances, dysregulation of the electrolyte and
acid-base balance, and disturbance of fluids. Although didactically helpful, the oversimplified
AKI classification of prerenal/renal/postrenal is currently considered obsolete. Indeed,
the boundaries blur quite quickly, particularly between prerenal and renal causes.
Based on the AKI pathophysiology, it can be etiologically divided into decreased renal
perfusion, postrenal obstruction and kidney specific injury or unspecific injury.
AKI is a common event in hospitalized patients and associates strongly with mortality
and chronic kidney disease (CKD). Today it is accepted that AKI and CKD are rather
an individually variable continuum, than 2 distinct entities. If AKI has not regressed
after 7 days, it is referred to as acute kidney disease (AKD). Persisting AKD for
> 90 days is classified as CKD. The transition from AKD to CKD is the result of an
incomplete and maladaptive repair process. Although follow-up of post-AKI patients
is essential, optimal concepts still need to be developed.
Schlüsselwörter
akutes Nierenversagen - akute Nierenschädigung - akute Nierenerkrankung
Key words
acute renal failure - acute kidney injury - acute kidney disease