an abrupt (within hours) decrease in kidney function, which encompasses both injury (structural damage) and impairment (loss of function).

Acute post-infectious glomerulonephritis, Lupus nephritis

more likely to develop chronic kidney disease in the future

present with listlessness, confusion, fatigue, anorexia, nausea, vomiting, weight gain, or edema

Patients can also present with oliguria (urine output less than 400 mL per day), anuria (urine output less than 100 mL per day), or normal volumes of urine (nonoliguric acute kidney injury)

development of uremic encephalopathy (manifested by a decline in mental status, asterixis, or other neurologic symptoms), anemia, or bleeding caused by uremic platelet dysfunction

The history should identify use of nephrotoxic medications or systemic illnesses that might cause poor renal perfusion or directly impair renal function.

Physical examination should assess intravascular volume status and any skin rashes indicative of systemic illness.

A high serum creatinine level in a patient with a previously normal documented level suggests an acute process, whereas a rise over weeks to months represents a subacute or chronic process.

guide the differential diagnosis and direct further workup

The presence of acute hemolytic anemia with the peripheral smear showing schistocytes in the setting of acute kidney injury should raise the possibility of hemolytic uremic syndrome

particularly in older men, to rule out obstruction (i.e., a postrenal cause)

for patients in whom prerenal and postrenal causes of acute kidney injury have been excluded and the cause of intrinsic renal injury is unclear.

If fluid resuscitation is required because of intravascular volume depletion, isotonic solutions (e.g., normal saline) are preferred over hyperoncotic solutions (e.g., dextrans, hydroxyethyl starch, albumin)

Attention to electrolyte imbalances (e.g., hyperkalemia, hyperphosphatemia, hypermagnesemia, hyponatremia, hypernatremia, metabolic acidosis) is important.

The key to management is assuring adequate renal perfusion by achieving and maintaining hemodynamic stability and avoiding hypovolemia.

Supportive therapies (e.g., antibiotics, maintenance of adequate nutrition, mechanical ventilation, glycemic control, anemia management) should be pursued based on standard management practices.

kerusakan pada pembuluh darah di ginjal. Kondisi ini disebut juga dengan ketoasidosis diabetikum.
menyebabkan gagal ginjal akut dan produksi urine menburuk