Notes

Introduction
kidney injury (AKI), previously called acute renal failure (ARF), denotes a sudden and often reversible reduction in kidney function, as measured by glomerular filtration rate (GFR).[1][2][3] However, immediately after a renal insult, blood urea nitrogen (BUN) or creatinine (Cr) levels may be within the normal range, and the only sign of AKI may be a decline in urine output. AKI can lead to the accumulation of water, sodium, and other metabolic products. AKI can also result in other electrolyte disturbances. AKI is a prevalent condition, especially among hospitalized patients, and can be seen in up to 7% of hospital admissions and 30% of ICU admissions.

Aim and objective
Acute kidney injury (AKI) is associated with significant morbidity and mortality. Timely recognition of patients at risk for AKI, or with possible AKI, is essential to allow early intervention to minimize further renal injury, and may likely result in better outcomes than treating established AKI.1 Protective measures to avoid worsening should be started immediately, with special attention to ensure adequate hydration, maintain hemodynamic stability and oxygenation, and prevent nephrotoxicity of drugs (Figure 1).2 Treatment goals in patients with AKI include: preservation and optimization of renal function; correction and maintenance of electrolyte, acid-base, and mineral homeostasis; minimize secondary organ damage from the consequences of AKI; and manage effects of decreased renal function. The spectrum of AKI includes rapid reversal of AKI, persistent AKI, and acute kidney disease (AKD) as defined previously

Methodology
AKI remains a public health concern with a paucity of therapeutic development. One angle to address this unresolved problem is to better subphenotype AKI and facilitate precision medicine approaches. The subphenotyping of AKI requires the use of specific methodologies suitable for interrogation of multimodal data inputs from different sources such as EHRs, organ support devices, and/or biospecimens and tissues. Some of these data encompass static and dynamic clinical parameters, pathobiological