Figure 3 Hypothetical trajectories of acute kidney disease (AKD)

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Figure 3 Hypothetical trajectories of acute kidney disease (AKD) Figure 3 | Hypothetical trajectories of acute kidney disease (AKD). AKD follows on from acute kidney injury (AKI) in those patients who do not fully recover within 7 days. The trajectory of AKD can take many forms largely depending on the severity of the initial AKI episode. Here, a series of hypothetical scenarios representing typical trajectories of the AKI–AKD continuum are depicted. Stage 3 AKI might slowly improve to stage 2 AKI and then progress to AKD (1). Stage 1 AKI might progress to stage 3, then improve rapidly to stage 1 AKI before progressing to stage 1 AKD (2). An episode of persistent AKI (>48 h) might be followed by a period of sustained reversal(*), then a second episode of AKI (‡) leading to AKD (3). Stage 2 AKI might rapidly reverse (4). Subacute AKD might occur wherein the first 7 days are marked with slowly worsening renal function that does not technically meet the criteria for AKI, and progress to Stage 3 AKD (5). This trajectory can be seen in patients treated with chronic nephrotoxic medications (for example, with aminoglycosides). Modified from Acute Dialysis Quality Initiative 16; www.adqi.org. Modified from Acute Dialysis Quality Initiative 16; www.adqi.org. Chawla, L. S. et al. (2017) Acute kidney disease and renal recovery: consensus report of the Acute Disease Quality Initiative (ADQI) 16 Workgroup Nat. Rev. Nephrol. doi:10.1038/nrneph.2017.2