الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 112 |  |  |
| | | from | 112 | | |
Abstract
AKI is increasing in incidence, likely in part due to increasing comorbidities.(2) The current definition of AKI is based on using the rise in serum creatinine or the decrease in urine output as markers to stage the severity of AKI, despite the many limitations of these markers in detecting early AKI.(5) The most widely used system for diagnosis of AKI is 2012 KDIGO AKI stages.(3) Clinical diagnosis of AKI is evolving, The terms pre-renal, intrinsic renal, and post-renal draw attention to the various pathophysiological mechanisms that underlie AKI, but they also suggest distinct disease pathways and downplay the fact that AKI is a clinical condition with a number of different, frequently concurrent, and overlapping causes. Renal hypo-perfusion associated AKI is referred to as to pre-renal AKI. This disorder is commonly thought to be fully reversible with the prompt initiation of appropriate therapy, which frequently involves the administration of fluids. However, such pathology can become complicated and progress to ATN, which is a type of intrinsic renal AKI.(49) Based on the anatomical part of the affected kidney parenchyma, intrinsic AKI can be classified as vascular, glomerular, tubular, or interstitial. In most cases of acute intrinsic AKI seen in critically ill patients, 80–90% of the cases are caused by either ischemic or toxic acute tubular necrosis. Renal vasculitis, acute interstitial nephritis, or acute glomerulonephritis account for the remaining 10–20% of intrinsic AKI cases.(170) Finally, post-renal AKI resulting from urinary tract obstruction occurs in 5-10% of AKI cases.(171) In many cases of AKI, multiple pathologies may occur simultaneously.
Many studies also classified AKI into CAAKI and HAAKI. HAAKI is defined as AKI occurring 48 hours or more after admission to a health care facility. Different studies had demonstrated the relation between the occurrence of HAAKI and many risk factors which include: older age, multiple comorbidities