Choosing Wisely Canada climate-conscious recommendations for critical care medicine.
Authors: Balan M, Bodley TF, Montazeripouragha A, Baharmand I, Yu ACM, Burns KEA, Murthy S, Canadian Critical Care Society (CCCS) and on behalf of the CCCS Choosing Wisely Canada Climate-Conscious Recommendations Working Group
Journal: Canadian journal of anaesthesia = Journal canadien d'anesthesie
mental health
psychology
open access
Abstract
Acute kidney injury (AKI) is a serious clinical problem with a prevalence of 5–12% in hospitalized patients and 50% or more in the intensive care unit (ICU) [–]. AKI is associated with a high mortality rate, especially in ICU patients and in those with severe AKI where it can exceed 50% []. Patients surviving an AKI episode may face progressive chronic kidney disease (CKD) and an increased risk of cardiovascular events [, ]. AKI is defined by a rise in serum creatinine and/or decrease in urine output based on the Kidney Disease: Improving Global Outcomes (KDIGO) criteria []. However, these markers reflect kidney dysfunction rather than structural injury and have inherent limitations, including a substantial detection lag and susceptibility to non-renal confounders such as muscle mass, fluid balance, liver disease, common medications, and renal replacement therapy []. This may lead to delays in diagnosis and missed opportunities for prevention and management [].