Acute kidney injury.

Acute kidney injury (AKI) - an abrupt deterioration in renal function - causes a rise in serum creatinine (SCr) or fall in urine output. It is common, occurring in up to 20% of hospital admissions. Importantly, even small rises in SCr are associated with increased risk of death and longer hospital stays. A 2009 National Confidential Enquiry into Patient Outcome and Death report found that a proportion of AKI in secondary care was avoidable. In addition, management of established AKI was 'good' less than half the time. In practice, AKI represents a heterogeneous group of conditions, encompassing impairments in both kidney structure and function. Delivering disease-specific treatment early in the course of AKI may improve outcomes. The provision of best-practice care for all will rely on a better understanding of risk, and frameworks of care that can be applied across a diverse patient group. © Royal College of Physicians 2015. All rights reserved.