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Acute Kidney Injury

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General information
== General information ==
The theme of SensUs 2024 is Kidney failure also referred to as acute kidney injury (AKI). Kidney failure is characterized by one or both kidneys losing their renal function, namely, the ability to filter waste matter from the blood. This results in an accumulation of waste in the bloodstream, altering the ionic homeostasis of the blood. There are 5 stages of kidney failure depending on glomerular filtration rate (GFR) which measures the blood filtration rates of the kidneys (in (mL/min)), with the preliminary signs advancing to kidney failure including fatigue, nausea, swelling, etc. <ref name="Ref2> End-stage renal disease - Diagnosis and treatment - Mayo Clinic. (2023, October 10). https://www.mayoclinic.org/diseases-conditions/end-stage-renal-disease/diagnosis-treatment/drc-20354538 </ref> Generally, the clearance of substances that are freely filtered but not secreted or reabsorbed by the kidneys is used to estimate the GFR in clinical settings, with creatinine meeting the criteria. <ref name="Ref4"> López-Giacoman, S., & Madero, M. (2015). Biomarkers in chronic kidney disease, from kidney function to kidney damage. World Journal of Nephrology, 4(1), 57. https://doi.org/10.5527/wjn.v4.i1.57 </ref>
Creatinine is a product of the metabolism of creatine, which is produced in the liver from three amino acids, methionine, arginine, and glycine, and stored in muscle to be used as a source of energy once phosphorylated. Creatinine is normally excreted through the kidneys. Healthy kidneys are responsible for filtering creatinine out of the bloodstream, as it is a freely filtered metabolite that is not secreted or reabsorbed. Consequently, during kidney failure when the GFR reduces, there is a buildup of high levels of creatinine in the blood. A standard range of serum creatinine levels (SCr) for healthy men is 0.7 - 1.3 mg/dL (61.9 - 114.9 µmol/L), and for healthy women is 0.6 – 1.1 mg/dL (53 – 97.2 µmol/L). <ref name="Ref5"> Creatinine blood test. (n.d.-b). Mount Sinai Health System. https://www.mountsinai.org/health-library/tests/creatinine-blood-test#:~:text=Normal%20Results,less%20muscle%20mass%20than%20men </ref> As diet and hydration has a negligible impact on serum creatinine levels, it serves as a reliable indicator of renal function. There is no cure for chronic kidney disease (CKD), although maintaining a proper diet and medications can slow the progression of the disease. A person with kidney failure needs to undergo dialysis treatment or kidney transplantation. These two treatments allow the normal, healthy functioning of the kidneys. <ref name="Ref6">World Kidney Day. (2019, June 7). Chronic Kidney Disease - World Kidney Day. World Kidney Day -. https://www.worldkidneyday.org/facts/chronic-kidney-disease/ </ref>
 
== History of Acute Kidney Injury ==
Some of the earliest knowledge about kidney and urinary diseases dates all the way back to 9000BC. It comes from the cradle of Western civilization, Mesopotamia, from the cuneiform clay tablets of Acadia, Assyria, and Babylon that contain references to urinary obstruction, stone, cysts, urethritis, stricture, and urethral discharge. In ancient Babylon physicians made diagnoses depending on the appearance of the urine. They treated symptoms with remedies derived from plants or minerals. Drugs were administered by blowing them through a tube into the urethra, most likely also to relieve urinary obstruction, and using alcohol as an anaesthetic. Much of the medical information generated in Mesopotamia was later transported to the Mediterranean, especially to Greece.<ref name = "Ref7> Geller, M. J., and Cohen, S. L. Kidney and urinary tract disease in ancient Babylonia, with translations of the cuneiform sources. Kidney International 1995; 47: 1811–1815.</ref> <ref name = "Ref8"> Mujais, S. The future of the realm: medicine and divination in ancient Syro-Mesopotamia. Am J Nephrol 1999; 19: 133–139.</ref>

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