Acute Kidney Events in Intensive Care Patients

Dear Colleagues,

As guest editor of a Special Issue of the Journal of Clinical Medicine entitled "Acute Kidney Events in Intensive Care Patients", I would like to invite you to contribute.

The aim of this Issue is to report the most recent data on renal function and its possible deterioration in critically ill patients. The kidney is a central organ in the management of intensive care patients, and thus deserves a great deal of attention with the sole aim of improving the prognosis of these patients.

In patients admitted to intensive care units (ICUs), adverse renal events frequently occur, significantly impacting mortality and morbidity. Acute kidney injury (AKI) is the most common adverse renal event. In fact, AKI occurs in almost 50% of these patients, leading not only to an increased risk of mortality, but also to deleterious systemic effects in survivors, predisposing them to cardiovascular disease and chronic kidney disease.

The organ failures associated with the development of AKI, and the acute complications that ensue, have prompted extensive research into its early identification, with the aim of improving the outcome of the critically ill. Variations in serum creatinine and urine output define AKI, with small variations in these parameters being associated with worse outcomes. As a result, a number of studies have focused on identifying blood and urine biomarkers, biomarkers of function or stress, in order to earlier diagnose impaired renal function in ICU settings.

Major adverse renal events (MAKE), including death, the need for renal replacement therapy (RRT), and worsening renal function, are now recognized as key determinants of patient outcome, particularly in ICUs. After much debate, the indication of RRT in AKI is now well established. This review provides an opportunity to review these indications in detail, and the arguments on which they are based.

Also, patients suffering from AKI treated with RRT would be confronted with serious associated adverse effects, the occurrence of which must be prevented through choosing and controlling the appropriate modality while being aware of its deleterious effects.

The short- and long-term prognosis of critical patients with ARF depends largely on the severity of the condition. Death is the most serious adverse effect, but surviving patients will experience other adverse effects such as cardiovascular events and chronic impairment of renal function. This review will take stock of the medium- and long-term deleterious effects associated with the occurrence of AKI.

Prof. Dr. Kada Klouche
Guest Editor

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