Long-term remote organ consequences following acute kidney injury

Shiao, Chih‐Chung; Wu, Pei‐Chen; Huang, Tao‐Min; Lai, Tai‐Shuan; Yang, Wei-Shun; Wu, Che‐Hsiung; Lai, Chun‐Fu; Wu, Vin‐Cent; Chu, Tzong‐Shinn; Wu, Kwan‐Dun

doi:10.1186/s13054-015-1149-5

Cited by 66 publications

(41 citation statements)

References 124 publications

(170 reference statements)

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“…These patients may nonetheless be vulnerable to further kidney damage and other adverse events. As has been shown previously, patients who have suffered an AKI event and 'recover' still carry a long-term increased risk of major adverse cardiac and kidney events 49,76 . Patients with AKD stage 0A might still require follow-up and could likely benefit from avoiding unnecessary nephrotoxic drugs.…”

Section: A Framework To Classify Akd and Recoverymentioning

confidence: 82%

Acute kidney disease and renal recovery: consensus report of the Acute Disease Quality Initiative (ADQI) 16 Workgroup

et al. 2017

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Section: A Framework To Classify Akd and Recoverymentioning

confidence: 82%

Acute kidney disease and renal recovery: consensus report of the Acute Disease Quality Initiative (ADQI) 16 Workgroup

et al. 2017

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“…The largest proportion in our study could be explained by the delay in the management of our patients related to the precarious socio-economic conditions of these and the lack of social security system. Factors such as sepsis, hypertension and cancer seem associated with the non recovery of renal function during AKI (35,36).…”

Section: Discussionmentioning

confidence: 99%

Comparative study of community acute kidney injury in young patients versus elderly patients in an internal medicine department in Abidjan (Côte d’Ivoire)

Yao¹,

Guei²,

Tia³

et al. 2016

J Renal Inj Prev

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IntroductionAcute kidney injury (AKI) is characterized by a sudden drop in glomerular filtration rate. It is commonly seen in our medical practice. Its incidence varies from 1.9% to 24.4% depending on the series (1-4). In intensive care units, this incidence is in the order of 20% to 50% (5). The etiologies of AKI vary from one region to the other of the world. In the West countries, septic shock, hyopovolemia, cardiogenic shock and post-operative AKI are the most common in adults (4). In Africa, the Implication for health policy/practice/research/medical education:In our study, we found that regardless of age, infection is the leading cause of acute kidney injury (AKI). Drug-induced AKI is more common in young adults. On the other hand, benign tumor of the urinary tract and malignant hypertension are more found in the elderly. In addition, mortality and non-recovery of renal function are higher in the elderly. The causes of death and the factors associated with mortality and non recovery of renal function differ in both groups. Please cite this paper as: Introduction:Numerous studies have shown that the recovery of renal function was slower and less complete in the elderly patients than in adults. Objectives: To compare the profile of acute kidney injury (AKI) of the young patients with that of the elderly patients. Patients and Methods: This is a prospective study carried out during the period from January 2010 to December 2015 in the department of Nephrology-Internal Medicine of the University hospital of Treichville. The diagnosis of AKI was retained according to Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Results: The mean age of patients was 26.8 ± 6 years in the young and 69.4 ± 7 years in the elderly. The proportion of males was 51.9% (55/106) in the young patients against 77.8% (84/108) in the elderly patients (P = 0.0001). The proportion of hypertension and diabetes in the elderly patients, respectively 30.6% and 36.1% was statistically higher than in the young patients (P = 0.001). However, human immunodeficiency virus (HIV) infection was more prevalent in the young patients (P = 0.0001). Anemia was observed in 84.9% in the young patients against 58.3% in the elderly patients (P = 0.001). It was severe in 34% among the young patients against 15.7% among the elderly patients (P = 0.002). The proportion of drug AKI was 17% in the young patients against 2.8% in the elderly patients (P = 0.0001). Malignant hypertension (P = 0.002) and urinary tract tumors (P = 0.001) were more observed in the elderly patients. Mortality was 31.1% in the young patients against 47.2% in the elderly patients (P = 0.011). Conclusion:The etiologies are the same with different proportions, except malignant hypertension observed only in the elderly patients. Mortality is higher in the elderly patients.

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“…[7][8][9][10][11] The conventional wisdom that AKI survivors with renal functional recovery tend to do well and be uneventful should be abandoned. [12][13][14] The severity, frequency and duration of AKI have been demonstrated to be associated with the ensuing incident CKD. 7,8,10 AKI and CKD have been seen as interconnected syndrome.…”

Section: Introductionmentioning

confidence: 99%

“…Many studies have identified that AKI is a major risk of ensuing chronic kidney disease (CKD) . The conventional wisdom that AKI survivors with renal functional recovery tend to do well and be uneventful should be abandoned . The severity, frequency and duration of AKI have been demonstrated to be associated with the ensuing incident CKD .…”

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confidence: 99%

Role of renin‐angiotensin system in acute kidney injury‐chronic kidney disease transition

2018

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Acute kidney injury (AKI) can increase the risk of developing incident chronic kidney disease (CKD). The severity, frequency and duration of AKI are crucial predictors of poor renal outcome. A repair process after AKI can be adaptive and kidney recovers completely after a mild injury. However, severe injury will lead to a maladaptive repair, which frequently progresses to nephron loss, vascular rarefaction, chronic inflammation and fibrosis. Although different mechanisms underlying AKI‐CKD transition have been extensively discussed, no definite intervention has been proved effective to block or to retard the transition until recently. In CKD, renin‐angiotensin system (RAS) inhibitor has been proved effective to slow down disease progression. Furthermore, RAS needs to be highlighted again in AKI‐CKD transition because recent animal studies have shown the activation of intra‐renal RAS after AKI, and RAS blockade can reduce the ensuing CKD and mortality. In patients with the complete renal recovery after AKI, administration of RAS inhibitor is associated with reduced risk of subsequent CKD as well. In this article, we will demonstrate the role of RAS in AKI‐CKD transition comprehensively. We will then emphasize the promising effect of RAS inhibitor on CKD prevention in patients recovering from AKI based on evidence from the bench to clinical research. All of these discussions will contribute to the establishment of reliable monitoring and therapeutic strategies for patients with functional recovery from AKI who can be most easily ignored.

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Long-term remote organ consequences following acute kidney injury

Cited by 66 publications

References 124 publications

Acute kidney disease and renal recovery: consensus report of the Acute Disease Quality Initiative (ADQI) 16 Workgroup

Acute kidney disease and renal recovery: consensus report of the Acute Disease Quality Initiative (ADQI) 16 Workgroup

Comparative study of community acute kidney injury in young patients versus elderly patients in an internal medicine department in Abidjan (Côte d’Ivoire)

Role of renin‐angiotensin system in acute kidney injury‐chronic kidney disease transition

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