Standard definition for all spectrum of myocardial ischemia/threat or “Heart Attack” are well established9-14. With the advent of diagnostic tools predominately biomarkers the definitions of “Heart Attack” has also evolved9. Similarly with the kidneys, the advent of renal injury biomarkers call for a new paradigm in AKI or “Kidney Attack”. The lack of symptoms and delays in conventional AKI markers highlight a greater impetus for this term “Kidney Attack” within such a framework as we have highlighted. It is also stressed that injury and function in the renal and cardiac sense or not synonymous. In addition physiological differences highlight that injury is not always associated with loss of function and vice versa. It is thus important we introduce the term “attack” to categorize stages of heightened risk that may or may not be associated with early renal functional decline.
Bio = cardiac or renal biomarkers; EF = ejection fraction , surrogate for cardiac function; EKGST = electrocardiogram ST segment; MI = myocardial injury/ infarction; N = Normal; RF = Renal Function; RI = renal injury/infarction; ST segments; Th = Thrombus; Sym = symptom; UO = urine output; ↑ increased; ↓ = decreased; ↓ = Trend; + = positive; - negative; ± equivocal
Figure 1: Proposed umbrella lay terms ‘heart attack’ and ‘kidney attack’ with parallel clinical syndromes.