Summary

• Commonly associated with sepsis, cardiovascular collapse, CHF, vascular surgery, nephrotoxins, antibiotics or other drugs, IV contrast, or urinary outflow obstruction.
• May present with flank pain, haematuria, hypertension or hypotension, oedema, lethargy, uraemia, or decreased urine output; however, often asymptomatic and only diagnosed by laboratory tests.
• An acute increase in serum creatinine is essential for diagnosis. Hyperkalaemia, hyperphosphataemia, metabolic acidosis, and elevated urea nitrogen are common.
• The mainstay of treatment is supportive care, with management of the underlying illness; correction of acid/base, electrolyte, and volume complications; removal and minimisation of nephrotoxins; and relief of any associated obstruction being key.
• Renal replacement therapy with dialysis may be required and is usually well tolerated.
• Failure to treat may be associated with clinical deterioration and death. Outcome is dependent upon the severity of the underlying disease.