Setting the Agenda

In March, the U.S. Centers for Disease Control and Prevention published data on trends in hospitalizations for kidney disease from 1980 through 2005 (1). During this 25-year period, there was a greater than 20-fold increase in hospitalizations for acute kidney injury (AKI), from an age-adjusted rate of 18 per 100,000 population in 1980 to 365 per 100,000 population in 2005. During the same period, hospitalizations for chronic kidney disease increased less than two-fold, from 74 to 138 per 100,000 population. Although the majority of kidney disease research has focused on chronic and end-stage disease, these data highlight the pressing need to understand the causes for this explosive increase in acute kidney disease and improve clinical strategies for its prevention and treatment.

Understanding the epidemiology of AKI has been hampered by the multiplicity of definitions that have been used in clinical studies (2). The need for a consensus definition and classification system for AKI was recognized by the Acute …