Emergence of the concept of acute kidney injury.

Acute kidney injury (AKI), a recently defined clinical entity, is an ailment that has afflicted humans from time immemorial. Its emergence as a disease follows by 50 years that of acute renal failure (ARF) after the Second World War. The medical model of ARF emerged as studies of the kidney in traumatic shock unraveled the pathophysiology of the disease and focused on its treatment with hemodialysis. ARF was reframed as AKI, based on the model that had been developed for chronic kidney disease, to incorporate the accrued epidemiologic data and present it as a public health model of disease that is potentially preventable and treatable at earlier stages of the disease.