DIAGNOSIS AND MANAGEMENT OF ACUTE KIDNEY INJURY IN HOSPITALIZED PATIENTS: A SYSTEMATIC LITERATURE REVIEW

Abstract

This is a critical synthesis of diagnostic criteria, pathophysiological class, and management of Acute Kidney Injury (AKI) in hospitalized adult patients, based on evidence-based healthcare (EBHC). The PRISMA protocol for systematic literature review was employed through qualitative and exploratory research. The search and selection of articles was carried out in the PUBMED/MEDLINE and Cochrane Library databases, temporally restricted to the period between 2021 and January 2026. Only systematic reviews containing original articles were included. The main results indicated a diversity in the recognition of AKI, with many cases going undetected. Clinical guidelines, such as the KDIGO 2012 studied in the articles, require more complex refinements than those proposed by KDIGO 2025, especially in the analysis of specific populations. Early identification and pathophysiological classification are essential for adequate management. Innovations are found in machine learning models, which demonstrate a high capacity for predicting AKI, despite the need for further studies and methodological expansion. Optimization of renal perfusion, the use of vasopressors, fluid management, and the establishment of hemodynamic targets are essential. Innovation in AKI intervention is based on knowledge and application of EBD (Epidemiological Behavioral Therapy).