Organ crosstalk: the role of the kidney

Li, Xiang; Hassoun, Heitham T.; Santora, Rachel J.; Rabb, Hamid

doi:10.1097/mcc.0b013e328332f69e

Cited by 177 publications

(118 citation statements)

References 76 publications

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“…partial explanation for the natural history of multiple organ dysfunctions in critically ill patients (9). In experimental studies in animals or healthy volunteers, acute lung injury adversely affected kidney function.…”

Section: Discussionmentioning

confidence: 99%

“…Experimental studies suggest that AKI may increase the risk of lung injury, chiefly via the activation of proinflammatory and proapoptotic pathways because of renal ischemia/reperfusion (9)(10)(11)(12)(13). Several lines of evidence suggest that mechanical ventilation and acute respiratory distress syndrome (ARDS) may have adverse effects on kidney function via three main mechanisms.…”

Section: Introductionmentioning

confidence: 99%

“…An increasing body of evidence points to deleterious interactions between kidney and lung dysfunctions (9). Experimental studies suggest that AKI may increase the risk of lung injury, chiefly via the activation of proinflammatory and proapoptotic pathways because of renal ischemia/reperfusion (9)(10)(11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

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Acute Respiratory Distress Syndrome and Risk of AKI among Critically Ill Patients

Darmon¹,

Clec’h²,

Adrie³

et al. 2014

Clinical Journal of the American Society of Nephrology

166

159

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Background and objectives Increasing experimental evidence suggests that acute respiratory distress syndrome (ARDS) may promote AKI. The primary objective of this study was to assess ARDS as a risk factor for AKI in critically ill patients.Design, setting, participants, & measurements This was an observational study on a prospective database fed by 18 intensive care units (ICUs). Patients with ICU stays .24 hours were enrolled over a 14-year period. ARDS was defined using the Berlin criteria and AKI was defined using the Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease criteria. Patients with AKI before ARDS onset were excluded.Results This study enrolled 8029 patients, including 1879 patients with ARDS. AKI occurred in 31.3% of patients and was more common in patients with ARDS (44.3% versus 27.4% in patients without ARDS; P,0.001). After adjustment for confounders, both mechanical ventilation without ARDS (odds ratio [OR], 4.34; 95% confidence interval [95% CI], 3.71 to 5.10) and ARDS (OR, 11.01; 95% CI, 6.83 to 17.73) were independently associated with AKI. Hospital mortality was 14.2% (n=1140) and was higher in patients with ARDS (27.9% versus 10.0% in patients without ARDS; P,0.001) and in patients with AKI (27.6% versus 8.1% in those without AKI; P,0.001). AKI was associated with higher mortality in patients with ARDS (42.3% versus 20.2%; P,0.001).Conclusions ARDS was independently associated with AKI. This study suggests that ARDS should be considered as a risk factor for AKI in critically ill patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Acute Respiratory Distress Syndrome and Risk of AKI among Critically Ill Patients

Darmon¹,

Clec’h²,

Adrie³

et al. 2014

Clinical Journal of the American Society of Nephrology

166

159

View full text Add to dashboard Cite

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“…99 A coincident imbalance of other organ systems, that is, heart, lungs, brain, liver and other organs) may coexist in the presence of AKI, suggesting that an underlying systemic mechanism may be accountable for multiorgan dysfunction and could also be responsible for the greater mortality observed in AKI. 100 The biological crosstalk between the kidney and other organs, an increased incidence of sepsis and progression to CKD in AKI patients appear to be, at least in part, mediated by immune mechanisms (Figure 1). 100 AKI has been shown to involve the contribution of multiple strategic players of innate immunity.…”

Section: Pathogenesismentioning

confidence: 99%

“…100 The biological crosstalk between the kidney and other organs, an increased incidence of sepsis and progression to CKD in AKI patients appear to be, at least in part, mediated by immune mechanisms (Figure 1). 100 AKI has been shown to involve the contribution of multiple strategic players of innate immunity. 101 Following acute damage, inflammation mediates additional renal injury and dendritic cells seem to be crucial in summoning action from other immune cells.…”

Section: Pathogenesismentioning

confidence: 99%

Acute kidney injury in HCT: an update

Lopes

Jorge

Neves

2016

Bone Marrow Transplant

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Acute kidney injury (AKI) is highly prevalent whether the patients undergo myeloablative or non-myeloablative hematopoietic cell transplantation (HCT); however, the pathogenesis and risk factors leading to AKI can differ between the two. The prognosis of AKI in patients receiving HCT is poor. In fact, AKI following HCT is associated not only with increased short-and long-term mortality, but also with progression to chronic kidney disease. Herein, the authors provide a comprehensive and up-to-date review of the definition and diagnosis, as well as of the incidence, pathogenesis and outcome of AKI in patients undergoing HCT, centering on the differences between myeloablative and non-myeloablative regimens. INTRODUCTIONHematopoietic cell transplantation (HCT) is currently used to treat numerous malignant (for example, multiple myeloma, leukemias and lymphomas) and non-malignant hematological disorders (for example, aplastic anemia, b-thalassemia, immunodeficiency disorders and inborn errors of metabolism), as well as solid tumors (for example, breast cancer and neuroblastoma), which are in other instances incurable.The two major HCT procedures, taking into consideration the conditioning regimen used, are myeloablative autologous and allogeneic HCT and non-myeloablative allogeneic HCT. On the one hand, myeloablative HCT utilizes the maximally tolerated dose of TBI with or without chemotherapy, or with chemotherapy alone. On the other hand, non-myeloablative HCT depends more on donor cellular immune effects and less on the cytotoxic effects of the preparative regimen to control the underlying disease. 1,2 It ultimately uses a lower dose conditioning regimen and can thus be offered to older patients, to those debilitated by additional comorbidities, or to high-risk, heavily pretreated patients, who would not tolerate myeloablative HCT, resulting in a consequent decrease in regimen-related toxicity and treatment-related mortality. [3][4][5] Acute kidney injury (AKI) is highly prevalent whether the patients undergo myeloablative or non-myeloablative regimens; however, the pathogenesis and risk factors leading to AKI can differ between the two. In fact, AKI in patients receiving HCT is associated not only with increased short-and long-term mortality as compared with patients with no AKI, but also with a higher rate of progression to chronic kidney disease (CKD). Herein, the authors provide a comprehensive and up-to-date review of the definition and diagnosis of AKI as well as of the incidence, risk factors, pathogenesis and outcome of AKI in patients undergoing HCT, centering on the differences between myeloablative and nonmyeloablative regimens.

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Transient Acute Kidney Injury in the Postoperative Period

Virgilio

Kim

2016

JAMA Surg

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Organ crosstalk: the role of the kidney

Cited by 177 publications

References 76 publications

Acute Respiratory Distress Syndrome and Risk of AKI among Critically Ill Patients

Acute Respiratory Distress Syndrome and Risk of AKI among Critically Ill Patients

Acute kidney injury in HCT: an update

Transient Acute Kidney Injury in the Postoperative Period

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