Acute kidney injury

Distant organ dysfunction in acute kidney injury

“…51 Several mechanisms have been suggested that may promote cardiac dysfunction during AKI. 56 Conversely, CKD is an independent risk factor for the development and ascertainment of AKI. [52][53][54][55] However, even in the absence of these conditions, cardiac dysfunction may still occur in the context of AKI.…”

“…Perhaps the most compelling evidence for the close interrelated connection between the heart and kidney is that AKI increases the risk of CKD development and progression. 56 Conversely, CKD is an independent risk factor for the development and ascertainment of AKI. 57 Furthermore, the majority of patients with CKD die as a result of cardiovascular complications rather than kidney disease, which can be treated with RRT.…”

Nephropathies

“…AKI patients have a higher risk of CKD and for ESRD, depending on the underlying pathophysiological circumstances . Hypertension and diabetes mellitus, among other factors, play a crucial role during the development of CKD …”

“…The pathomechanisms are multiple as follows: (i) renal ischaemia and reperfusion injury (IRI) cause renal tubular and endothelial cell necrosis, apoptosis and inflammation, (ii) sepsis-induced organ dysfunction, (iii) nephrotoxic substances like radio-contrast dyes, chemotherapeutics, heavy metals, but also antibiotics and non-steroidal anti-inflammatory drugs and (iv) further organ failures like hepatic malfunction or even multi-organ failure 5,2 AKI often leads to retention of metabolic waste products and ranges from a decreased GFR to complete loss of renal function. 2,5 Current treatments focus on avoiding the potential injury due to nephrotoxic drugs or intravenous contrast agents and on providing supportive care. Identifying biomarkers or the development of tools for early diagnosis of AKI therefore is the most promising therapeutic concept to combat AKI and subsequent damage.…”

“…7 AKI patients have a higher risk of CKD and for ESRD, depending on the underlying pathophysiological circumstances. 5 Hypertension and diabetes mellitus, among other factors, play a crucial role during the development of CKD. 8 In a high number of diabetic patients, accumulation of the basal membrane and renal glomeruli is observed, in combination with a decrease in the GFR and the development of hypoxia.…”