通常与以下因素有关：脓毒症、血容量减少和/或低血压（肾前性 AKI 和肾性 AKI）；肾毒素（例如庆大霉素等氨基糖苷类抗生素、静脉用碘化造影剂、乙二醇）或较为罕见的 AKI 形式，例如血管炎或间质性肾炎（肾性 AKI）；或者尿液流出道梗阻（肾后性 AKI）
如果出现血清肌酐急性升高和/或尿量减少，则怀疑 AKI。更严重的 AKI 可能并发高钾血症和酸中毒伴尿毒症性脑病或心包炎。AKI 继发于梗阻性尿路病或肾动脉狭窄的患者也可能发生肺水肿（一过性肺水肿），但通常是医源性的，由过度液体复苏导致
及时识别和治疗很重要；急症入院患者中 10% 至 20% 存在 AKI，该病住院死亡率 >20%（3 期 AKI >35%）
Andrew Lewington, BSc (Hons), MBBS, MEd, MD, FRCP
Consultant Renal Physician
Honorary Associate Professor
Leeds Teaching Hospitals NHS Trust
AL is Associate Clinical Director of NIHR Leeds In-Vitro Diagnostics Co-operative, Co-Chair of UK Kidney Research Consortium Renal Clinical Study Group, Member of Kidney Research UK Research Grant Committee, Committee Member of NICE Kidney Injury Clinical Guideline Update 2018-20, Committee Member of NICE Diagnostic Assessment for Point of Care Creatinine Testing 2018-19. AL attended the Acute Dialysis Quality Initiative Meeting in San Diego 2018 (accommodation expenses); AL was a speaker at the AKI & CRRT Conference in San Diego 2019 (travel and accommodation expenses), the AKI Conference in Coventry 2019 (travel expenses), and the NIHR AKI and Sepsis Meeting in Leeds 2019 (no expenses).
BMJ Best Practice would like to gratefully acknowledge the previous expert contributor, whose work has been retained in parts of the content:
Richard A. Lafayette MD
Professor of Medicine
Stanford University Medical Center
RAL works as a consultant and researcher for Relypsa, Inc. Although unrelated to this topic area, RAL also works as a consultant for Fibrogen, Inc.; Mallinckrodt, Inc.; and Omeros, Inc.; and as a researcher for Genentech, Inc.; Mallinckrodt, Inc.; GlaxoSmithKline, Inc.; Rigel, Inc.; Aurinia, Inc.; and the NIH.
Newcastle upon Tyne Hospitals NHS Trust
Newcastle Hospitals Haemodialysis Service
Honorary Clinical Senior Lecturer
SK was an expert adviser to the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) report into AKI and is lead author of the UK Renal Association clinical practice guideline on AKI.
Section Editor, BMJ Best Practice
Consultant in Paediatric Emergency Medicine
Royal London Hospital
TD declares that she has no competing interests.
Head of Editorial, BMJ Knowledge Centre
JH declares that she has no competing interests.
Comorbidities Editor, BMJ Best Practice
JC declares that she has no competing interests.
Drug Editor, BMJ Best Practice
AM declares that he has no competing interests.