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From the University of Maryland Medical Center in Baltimore (Dr Lattanzio) and Nephrology Hypertension Associates of the Lehigh Valley in Easton, Pa (Dr Kopyt).

Address correspondence to Michael R. Lattanzio, DO, 22 S Greene St N3W 143, Department of Nephrology, Baltimore, MD 21201-1544. E-mail: MLattanzio{at}gmail.com

Acute kidney injury (AKI) is increasingly recognized in all fields of medical practice. Unfortunately, this syndrome has been plagued by inconsistent definitions, simplistic pathophysiologic schemas, and insensitive diagnostic tools. Recent advances in defining AKI, understanding its pathophysiology, and improving the diagnostic accuracy of the testing tools available eventually will impact disease management and clinical outcomes. Prompt recognition and treatment of AKI remain the cornerstone of clinical management for this high-mortality, high-cost syndrome. The authors provide the most recent updates in the definition, diagnosis, pathophysiology, and treatment options for patients with AKI, providing a stepwise approach to clinical evaluation for use in all fields of medical practice.