Key Difference – Acute Kidney Injury (AKI) vs Chronic Kidney Disease (CKD)
Acute Kidney Injury (AKI) occurs as an abrupt loss of kidney function over hours to weeks and is usually reversible (but not invariably).Chronic Kidney Disease (CKD) arises as a result of progressive loss of kidney function over a period of months or years which leads to irreversible damage.This is thekey difference在急性肾脏损伤和慢性肾脏疾病之间。这两者之间的进一步差异将在本文中讨论。
What is Acute Kidney Injury (AKI)?
Acute Kidney Injury has now replaced the termAcute Renal Failure(ARF). AKI is potentially treatable; however, a minor reduction of kidney function has an adverse prognosis. The common definition of AKI for practice, research and public health is as follows.
Increase in sCr by ≥ 0.3mg/dl (26.5 μmol/l) within 48 hours; or
SCR的增加到≥1.5倍的基线，这是已知或假定在前7天内发生的；或者
Urine volume < 0.5ml/kg/hr for 6 hours
两个类似的定义；步枪 - 风险，伤害失败，功能丧失，终阶段肾脏疾病和AKIN - 急性肾脏损伤网络也已被提出并验证以定义AKI的定义和分期。
Signs and Symptoms
There are several signs and symptoms associated with Acute Kidney Injury.
皮肤：Livido reticularis, Maculopapular rash, Track marks
眼睛：Keratitis,黄疸，多发性骨髓瘤，迹象diabetes mellitus,和高血压
Ears:Hearing loss
Cardiovascular System:不规则的节奏，杂音，心心摩擦
腹部：Pulsatile mass, Abdominal tenderness,Edema
Pulmonary System:Rales, Hemoptysis
Pathologic kidney specimen showing marked pallor of the cortex, contrasting to the darker areas of surviving medullary tissue.
What is Chronic Kidney Disease (CKD)?
According to the national kidney foundation guidelines, CKD can be defined as,
肾脏损伤≥3个月，由肾脏的结构或功能异常定义，肾小球滤过率（GFR）表现为病理异常或肾脏损伤标记，包括血液或尿液或尿液组成的异常，成像测试中的异常。
GFR <60ml/min/1.73m2≥3个月，有或没有肾脏损伤。
Signs and Symptoms
代谢性酸中毒，水肿的迹象 - 外周和肺，高血压，疲劳，腹膜炎，脑病，外周神经病，躁动不安的腿综合征，胃肠道症状，皮肤表现，皮肤表现，Malnutrition, Platelet dysfunction are signs and symptoms of CKD.
What are the differences between Acute Kidney Injury and Chronic Kidney Disease?
Causes of Acute Kidney Injury and Chronic Kidney Disease
AKI:AKI occurs due to the sudden reduction of kidney function over hours to weeks.
CKD:CKDoccurs due to progressive loss of renal function.
Reversibility
AKI:AKI is reversible in most of the times.
CKD:CKDcannot be revised.
Etiology of Acute Kidney Injury and Chronic Kidney Disease
AKI:Etiology of AKI can be divided into 3 categories; pre-renal (caused by decreased renal perfusion), intrinsic renal (caused by a process within kidneys) and post-renal (caused by inadequate drainage of urine distal to the kidneys)
CKD:CKDcan be a manifestation of other chronic illnesses such as diabetes mellitus, hypertension or glomerulonephritis.
Diagnosis of Acute Kidney Injury and Chronic Kidney Disease
AKI:Early diagnosis of AKI can be difficult using traditional biomarkers such as serum cratinine as it takes more than 48 hours to appear in serum after injury. Therefore, more sensitive and specific biomarkers are needed for AKI.
CKD:CKDcan be diagnosed with conventional laboratory tests.
参考：
K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification.Am J Kidney Dis,39,S1-266。
Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO Clinical Practice Guideline for Acute Kidney Injury.Kidney International Supplements2,18-20。
ARORA, P. 2015.Chronic Kidney Disease[Online]. Available:http://emedicine.medscape.com/article/238798-overview[Accessed June 13th 2016].
Biruth，T.2015。Acute Kidney Injury[Online]. Available:http://emedicine.medscape.com/article/243492-overview[Accessed June 13th 2016].
CRUZ, D. N., RICCI, Z. & RONCO, C. 2009. Clinical review: RIFLE and AKIN–time for reappraisal.Crit Care,13,211.
WAIKAR, S. S. & BONVENTRE, J. V. 2009. Creatinine kinetics and the definition of acute kidney injury.J Am Soc Nephrol，20,672-9.
Image Courtesy
Blausen.com工作人员的“ Blausen 0592 Negneyanatomy”。“ Blausen Gallery 2014”。Wikiversity医学杂志。doi：10.15347/wjm/2014.010。ISSN 20018762. - （自己的工作，CC By 3.0）Commons Wikimedia
“Kidney – acute cortical necrosis” ByHaymanj– Own work (own photo) (Public Domain) viaCommons Wikimedia
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