Akute und chronische Nierenerkrankungen in der Differenzialdiagnose einer akuten Nierenfunktionsstörung

Many different etiological and morphological kidney diseases first become noticeable through acute kidney dysfunction (acute kidney injury, AKI). Such intrarenal kidney diseases can easily be overlooked or recognized late; however, a rapid diagnosis is important in order to initiate a specific treatment and to prevent chronic kidney damage.

To provide an overview of the differential diagnosis in AKI. especially on the intrarenal causes and to develop a diagnostic algorithm to assist in everyday clinical practice.

Analysis of review articles and case series. Review and discussion of guidelines and expert recommendations.

AKI is a common complication in patients undergoing inpatient treatment, particularly in intensive care units. It leads to increased morbidity and mortality. Due to the demographic developments, lifestyle habits and climate change, it can be assumed that the frequency of AKI will increase and that many people will have an increased risk of resulting chronic kidney damage due to previous illnesses and age.

AKI is a clinical sign and not a unique disease entity. A rapid and comprehensive search for the cause is necessary. It is important to correctly differentiate between prerenal, intrarenal and postrenal causes. The specific cause should be identified whenever possible, as from this many therapeutic consequences can be derived.