ESPN 51th Annual Meeting

ESPN 2018


 
THE EVOLVING DEFINITION OF ACUTE KIDNEY DISEASE (AKD): SYSTEMATIC SCOPING REVIEW
ELENA KULAKOVA 1 TATJANA NASTAUSHEVA 1 TATJANA ZVYAGINA 1

1- VORONEZH STATE MEDICAL UNIVERSITY
 
Introduction:

Consensus definitions have been reached for both acute kidney injury (AKI) and chronic kidney disease (CKD). In 2012, the KDIGO Work Group proposed an operational definition for acute kidney diseases and disorders by defining it as an acute condition including AKI, a glomerular filtration rate (GFR) < 60 ml/min/1.73m2, a decrease in GFR by ≥ 35%, an increase in serum creatinine by > 50%, or any kidney damage lasting less than 3 months. Since that time, the definition for acute kidney disease (AKD) has been evolving and now varies among researchers. For practitioners, the concept of AKD is still relatively new. We aimed to describe the evolution and current state of the AKD definition using a scoping review methodology.

Material and methods:

A MEDLINE search for the term “acute kidney diseas*” was conducted. We applied EPPI-Reviewer 4 Software to manage and analyze data. To identify additional articles, we did a hand-search.

Results:

A total of 126 papers were found (121 through the database search, 5 through the hand search). The chief inclusion criterion was the use of the AKD term with a clear definition. Twenty-one items were eligible for review, only 5 of which were primary studies. The KDIGO definition was used in 11 articles. The definition proposed by the Acute Disease Quality Initiative (ADQI) in 7 articles. In 3, primary studies researchers used their own AKD definitions. The main reasons for applying the term were to define any alterations in kidney function or structure that do not meet the criteria for AKI and CKD, and to describe a period of renal recovery after AKI.

Conclusions:

Our systematic scoping review synthesized available literature on AKD definitions and found that the existing conceptual models for AKD are diverse. These results can be used to increase awareness of AKD and emphasize the need for a universally accepted definition.