AKI

(ACUTE KIDNEY INJURY)

Dr. Widodo, Sp.PD, KGH
Dr. Nina Oktafianti
Highlights
1 Epidemiology

2 Definition

3 Staging

4 Faktor risiko dan Etiologi

5 Patophysiology

6 Diagnosis

7 Complication

8 Prognosis
 1. Epidemiology

Incidence rates of AKI were 21.6% in adults

1 in 5 adults worldwide experience AKI during a hospital
episode of care
The pooled AKI-associated mortality rates were 23.9% in
adults

(Clin J Am Soc Nephrol, 2013 )

(US Renal Data System, 2012)
 2. Definition
Acute kidney injury (AKI), previously known as Acute Renal
Failure
In 2011 Acute Kidney Injury (KDIGO)
(Kidney Disease Initiative Global Outcome /KDIGO, 2012)
3. Staging
4. Faktor risiko
Etiologi

Harisson, 19th edition

 5. Patofisiologi

Harisson, 19th edition

Proses perjalanan AKI
 6. Diagnosis
Kriteria Diagnosis AKI (KDIGO, 2012):
- Peningkatan kreatinin serum 0,3 mg/dl ( 26,4mol/l)
ATAU
- Peningkatan kreatinin serum 1,5 kali (>50%) dibanding
dengan kadar baseline yang diketahui dan diduga terjadi
peningkatannya dalam 1 minggu
ATAU
- Penurunan produksi urin kurang dari 0,5 cc/jam selama
lebih dari 6 jam.
 Pemeriksaan penunjang:
1. Biokimia darah: Creatinin serum, Urea nitrogen (BUN), eGFR,
DL
2.Pemeriksaan urin: produksi urin, urin analisis, osmolalitas, fraksi
ekskresi natrium, pemeriksaan sedimen
3. Imaging
4. Penanda biologis: masih dalam penelitian
 7. Complication

Uremia Asidosis Infection

Hipervolemia Hiperfosfatemia Cardiac

complication
&Hipocalsemia
Hiponatremia
Bleeding Malnutrisi
Hyperkalemia
 8. Tatalaksana

Terapi Konservatif
1.

Terapi pengganti ginjal: Peritoneal dialisis,

Hemodialisis, CRRT (Continuous
2. Replacement Renal Theraphy
 9. Prognosis

Evaluate patients 3 months after AKI resolution, new onset, or

worsening of pre-existing CKD