LAUSR

A cute kidney injury (AKI) is defined by Kidney Disease: Improving Global Outcome (KDIGO) consensus criteria based on increase in serum creatinine (SCr) and decrease in urine output, which aim to capture an abrupt drop in glomerular filtration rate (GFR). Although most instances of injury to kidney tubules are accompanied by a drop in GFR and a subsequent increase in SCr, there are settings in which there is a discordance between the two. For example, during intensive blood pressure control or therapy with inhibitors of the renin angiotensin aldosterone system, AKI defined by SCr increase is not accompanied by kidney injury and causes false alarm. Perhaps a bigger problem in sepsis-related AKI is that SCr might not increase despite injury to the kidneys. This could be due to a decrease in SCr production or its dilution from i.v. fluid administration. It could also be due to unfavorable kinetics of SCr, which does not increase for 24 to 48 hours after kidney injury has