Conservatism strikes back: later is better than earlier dialysis for acute kidney injury

Acute kidney injury (AKI) is not a disease but rather a clinical syndrome with multiple etiologies, and often is the result of multiple concurrent insults to the kidney. The definition of AKI is any of the following—increase in serum creatinine by 0.3 mg/dL within 48 hours; or increase in serum creatinine to 1.5 times baseline level, which is known or presumed to have occurred within the past week; or Urine volume of less than 0.5 mL/kg/h for 6 hours. Quite frequently an AKI event occurs in the setting of an underlying CKD, so that it is said that AKI is a marker of preexisting CKD (1,2).