Acute kidney injury in China: a cross-sectional survey

Li, Yang; Xing, Guolan; Wang, Li; Wu, Yuangang; Li, Suhua; Xu, Gang; He, Qiang; Chen, Jianghua; Chen, Menghua; Liu, Xiaohua; Zhu, Zaizhi; Yang, Lin; Lian, Xin; Ding, Feng; Li, Yun; Wang, Huamin; Wang, Jianqin; Wang, Rong; Mei, Changlin; Xu, Jixian; Li, Rongshan; Cao, Juan; Zhang, Liang; Wang, Yan; Xu, Jinhua; Bao, Bin; Liu, Bi‐Cheng; Chen, Hongyu; Li, Shaomei; Zha, Yan; Luo, Qian; Chen, Dongcheng; Shen, Yulan; Liao, Yunhua; Zhang, Zhengrong; Wang, Xianqiu; Zhang, Kun; Liu, Luojin; Mao, Peiju; Guo, Chunxiang; Li, Jiangang; Wang, Zhenfu; Bai, Shoujun; Shi, Shuangjie; Wang, Yafang; Wang, Jinwei; Liu, Zhangsuo; Wang, Fang; Huang, Dandan; Wang, Shun; Ge, Shuwang; Shen, Quanquan; Zhang, Ping; Wu, Lei; Pan, Miao; Zou, Xiting; Zhu, Ping; Zhao, Jin; Zhou, Minjie; Hu, Wenping; Wang, Jing; Liu, Bing; Zhang, Tong; Han, Jianxin; Wen, Tao; Zhao, Minghui; Wang, Haiyan

doi:10.1016/s0140-6736(15)00344-x

Cited by 376 publications

(370 citation statements)

References 19 publications

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“…Recently, the ISN 0by25 China consortium launched a nationwide survey on AKI in mainland China [4] which screened 2.2 million hospitalized adult patients in 44 academic/local general hospitals across the country. The detection rate of AKI was 1% according to KDIGO criteria and 2% according to expanded criteria (≥50% change during hospital stay) with an in-hospital mortality rate of 12.4%.…”

Section: Epidemiology Of Aki In Asiamentioning

confidence: 99%

“…According to the nationwide multicenter survey on AKI in China, around 30% of AKI cases are treated in the ICU [4]. The incidence of AKI is 30-50% in total ICU admissions, with 30% of the AKI cases reaching stage 3 and 27% dying during the hospital stay [14,15].…”

Section: Epidemiology Of Aki In Asiamentioning

confidence: 99%

“…In China, around 40% of AKI is due to drug toxicity [5]. Nearly 70% of the AKI patients had had nephrotoxic medication exposure before or at the time when AKI developed [4], which indicates a negligible role of drug toxicity in triggering and promoting kidney injury in the majority of AKI patients. …”

Section: Causes and Patterns Of Aki In Asiamentioning

confidence: 99%

“…Of the diverse medicines that can cause AKI, antimicrobial agents, nonsteroidal anti-inflammatory drugs, and herbal medicine are the most common types of nephrotoxic drugs in China [4,5]. In rural areas and tropical regions, herbal medicine plays a predominant role in causing drug-toxic AKI.…”

Section: Causes and Patterns Of Aki In Asiamentioning

confidence: 99%

“…In China, environmental nephrotoxins contribute to 3-4% of CA-AKI entities and are more frequent in southern regions at a northern latitude of 20-30° [4]. In Southern Asia and Southeastern Asia, the rate may be up to 10% [40].…”

Section: Causes and Patterns Of Aki In Asiamentioning

confidence: 99%

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Acute Kidney Injury in Asia

Yang¹

2016

Kidney Dis

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Background: Acute kidney injury (AKI) is a common disorder and is associated with a high morbidity and mortality worldwide. The diversity of the climate and of the socioeconomic and developmental status in Asia has a great influence on the etiology and presentation of AKI in different regions. In view of the International Society of Nephrology's 0by25 initiative, more and more attention has been paid to AKI in Asian countries. Summary: In this review, we summarize the recent achievements with regard to the prevalence and clinical patterns of AKI in Asian countries. Epidemiological studies have revealed the huge medical and economic burden of AKI in Eastern Asian countries, whereas the true epidemiological picture of AKI in the tropical areas is still not well understood. In high-income Asian regions, the presentation of AKI resembles that in other developed countries in Europe and North America. In low-income regions and tropical areas, infections, environmental toxins, and obstetric complications remain the major culprits in most cases of AKI. Preventive opportunities are missed because of failure to recognize the risk factors and early signs of AKI. Patients often present late for treatment or are recognized late by physicians, which leads to more severe kidney injury, multiorgan involvement, and increased mortality. There is significant undertreatment of AKI in many regions, and medical resources for renal replacement therapy are not universally available. Key Messages: More efforts should be made to increase public awareness, establish preventive approaches in communities, educate health-care practitioner entities to achieve better recognition, and form specialist renal teams to improve the treatment of AKI. The choice of renal replacement therapy should fit patients' needs, and peritoneal dialysis can be practiced more frequently in the treatment of AKI patients. Facts from East and West: (1) More than 90% of the patients recruited in AKI studies using KDIGO-equivalent criteria originate from North America, Europe, or Oceania, although these regions represent less than a fifth of the global population. However, the pooled incidence of AKI in hospitalized patients reaches 20% globally with moderate variance between regions. (2) The lower incidence rates observed in Asian countries (except Japan) may be due to a poorer recognition rate, for instance because of less systematically performed serum creatinine tests. (3) AKI patients in South and Southeastern Asia are younger than in East Asia and Western countries and present with fewer comorbidities. (4) Asian countries (and to a certain extent Latin America) face specific challenges that lead to AKI: nephrotoxicity of traditional herbal and less strictly regulated nonprescription medicines, environmental toxins (snake, bee, and wasp venoms), and tropical infectious diseases (malaria and leptospirosis). A higher incidence and less efficient management of natural disasters (particularly earthquakes) are also causes of AKI that Western countries are less likely to...

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Section: Epidemiology Of Aki In Asiamentioning

confidence: 99%

Section: Epidemiology Of Aki In Asiamentioning

confidence: 99%

Section: Causes and Patterns Of Aki In Asiamentioning

confidence: 99%

Section: Causes and Patterns Of Aki In Asiamentioning

confidence: 99%

Section: Causes and Patterns Of Aki In Asiamentioning

confidence: 99%

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Acute Kidney Injury in Asia

Yang¹

2016

Kidney Dis

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Layer‐by‐Layer Assembly of Renal‐Targeted Polymeric Nanoparticles for Robust Arginase‐2 Knockdown and Contrast‐Induced Acute Kidney Injury Prevention

Gu,

Tai,

Liu

et al. 2024

Adv Healthcare Materials

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The mitochondrial enzyme arginase‐2 (Arg‐2) is implicated in the pathophysiology of contrast‐induced acute kidney injury (CI‐AKI). Therefore, Arg‐2 represents a candid target for CI‐AKI prevention. Here, we developed layer‐by‐layer (LbL) assembled renal‐targeting polymeric nanoparticles to efficiently deliver small interfering RNA (siRNA), knockdown Arg‐2 expression in renal tubules, and evaluated prevention of CI‐AKI. Firstly, near‐infrared dye‐loaded poly(lactic‐co‐glycolic acid) (PLGA) anionic cores were electrostatically‐coated with cationic chitosan (CS) to facilitate the adsorption and stabilization of Arg‐2 siRNA. Next, nanoparticles were coated with anionic hyaluronan (HA) to provide protection against siRNA leakage and shielding against early clearance. Sequential layering of electrostatically adsorbed CS and HA improved loading capacity of Arg‐2 siRNA and yielded LbL‐assembled nanoparticles. Renal targeting and accumulation was enhanced by modifying the outermost layer of HA with a kidney targeting peptide (HA‐KTP). The resultant PLGA/CS/HA‐KTP siRNA nanoparticles exhibited proprietary accumulation in kidneys and proximal tubular cells at 24 hours post‐tail vein injection. In iohexol‐induced in vitro and in vivo CI‐AKI models, PLGA/CS/HA‐KTP siRNA nanoparticles alleviated oxidative and nitrification stress, and rescued mitochondrial dysfunction while reducing apoptosis, thereby demonstrating a robust and satisfactory therapeutic effect. Thus, PLGA/CS/HA‐KTP siRNA nanoparticles offer a promising candidate therapy to protect against CI‐AKI.This article is protected by copyright. All rights reserved

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Self‐Assembling P38 Peptide Inhibitor Nanoparticles Ameliorate the Transition from Acute to Chronic Kidney Disease by Suppressing Ferroptosis

Xin,

Gong,

Chen

et al. 2024

Adv Healthcare Materials

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Accumulating evidence highlights p38 as a crucial factor highly activated during the process of acute kidney injury (AKI), but the application of p38 inhibitor in AKI was quite limited due to the low efficiency and poor kidney‐targeting ability. Herein, a novel self‐assembling peptide nanoparticle with specific p38‐inhibiting activity was constructed, which linked mitogen‐activated protein kinase kinase 3b (MKK3b), the functional domain of p38, with the cell‐penetrating TAT sequence, ultimately self‐assembling into TAT‐MKK3b nanoparticles (TMNPs) through tyrosinase oxidation. Subsequent in vitro and in vivo studies demonstrated that TMNPs preferably accumulated in the renal tubular epithelial cells (RTECs) through forming protein coronas by binding to albumin, and strongly improved the reduced renal function of ischemia‐reperfusion injury (IRI)‐induced AKI and its transition to chronic kidney disease (CKD). Mechanically, TMNPs inhibited ferroptosis via its solute carrier family 7 member 11 (SLC7A11)/glutathione peroxidase 4 (GPX4) axis‐inducing capacity and synergistic potent antioxidant property in AKI. Our findings indicated that the multifunctional TMNPs exhibited renal targeting, ROS‐scavenging and ferroptosis‐mitigating capabilities, which may serve as a promising therapeutic agent for the treatment of AKI and its progression to CKD.This article is protected by copyright. All rights reserved

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Acute kidney injury in China: a cross-sectional survey

Cited by 376 publications

References 19 publications

Acute Kidney Injury in Asia

Acute Kidney Injury in Asia

Layer‐by‐Layer Assembly of Renal‐Targeted Polymeric Nanoparticles for Robust Arginase‐2 Knockdown and Contrast‐Induced Acute Kidney Injury Prevention

Self‐Assembling P38 Peptide Inhibitor Nanoparticles Ameliorate the Transition from Acute to Chronic Kidney Disease by Suppressing Ferroptosis

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