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Acute Kidney Injury: Latest Advances and Prospects
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Acute Kidney Injury: Latest Advances and Prospects

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Nephrology & Urology".

Deadline for manuscript submissions: 30 June 2025 | Viewed by 1068

Special Issue Editors

Dr. Emanuele de Simone

E-Mail Website
Guest Editor
University Center of Excellence on Nephrologic, Rheumatologic and Rare Diseases (ERK-net, ERN-Reconnect and RITA-ERN Member) with Nephrology and Dialysis Unit and Center of Immuno-Rheumatology and Rare Diseases (CMID), Coordinating Center of the Interregional Network for Rare Diseases of Piedmont and Aosta Valley (North-West Italy), San Giovanni Bosco Hub Hospital, and Department of Clinical and Biological Sciences of the University of Turin, 10154 Turin, Italy
Interests: AKI; kidney replacement therapies; diabetic nephropathy; APS nephropathy; green nephrology
Dr. Kianoush Kashani

E-Mail Website
Guest Editor
1. Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
2. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
Interests: AKI; AKI biomarkers; acid-base and electrolytes; kidney replacement therapies; extracorporeal blood purification strategies; ECMO; fluid management; simulation medicine; point-of-care ultrasonography; artificial intelligence and digital health

Special Issue Information

Dear Colleagues,

Acute kidney injury (AKI) is a complex issue with far-reaching implications, associated with substantial morbidity and mortality rates. AKI places a significant burden on healthcare systems, requiring intensive care and specialized interventions. By delving into the complexities of AKI, healthcare professionals and researchers can improve patient care and reduce the burden of this condition.

This Special Issue aims to explore different aspects of AKI, from various presentation clinical settings to diagnosis and renal replacement therapies, with an eye to future developments and “green solutions”.

This Special Issue seeks to stimulate discussion among researchers and clinicians on AKI management, comparing various clinical experiences and comprehensive literature reviews.

Every scientific contribution to this Special Issue will enrich the ongoing dialogue on AKI. We invite all interested parties to participate and share their unique viewpoints. AKI is a complex condition that transcends nephrology and impacts the daily work of many healthcare providers. A truly comprehensive understanding of AKI can only be achieved through a multidisciplinary approach.

Dr. Emanuele de Simone
Dr. Kianoush Kashani
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • acute kidney injury (AKI)
  • sepsis
  • septic shock
  • renal replacement therapy
  • intensive care
  • specialized interventions
  • biomarkers
  • risk factors
  • “Green Practice”
  • nephrology
  • epidemiology
  • multidisciplinary approach

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

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Research

14 pages, 3744 KiB  
Article
The Association Between Central Venous Pressure and Acute Kidney Injury Development in Patients with Septic Shock
by Nasrin Nikravangolsefid, Jacob Ninan, Supawadee Suppadungsuk, Waryaam Singh and Kianoush B. Kashani
J. Clin. Med. 2025, 14(9), 3027; https://doi.org/10.3390/jcm14093027 - 27 Apr 2025
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Abstract
Background: Sepsis-associated acute kidney injury (AKI) is linked to increased mortality and prolonged hospital stays. The exact relationship between central venous pressure (CVP) and AKI remains unclear. We explored the correlation between CVP and AKI in septic shock patients. Methods: This retrospective study [...] Read more.
Background: Sepsis-associated acute kidney injury (AKI) is linked to increased mortality and prolonged hospital stays. The exact relationship between central venous pressure (CVP) and AKI remains unclear. We explored the correlation between CVP and AKI in septic shock patients. Methods: This retrospective study included adult patients with septic shock admitted to Mayo Clinic Rochester between 2006 and 2018. CVP levels were measured at 6, 12, 24, and 48 h after the diagnosis of sepsis, and patients were stratified into two groups based on CVP levels (CVP < 8 or ≥8 mmHg). Results: Of 5600 patients with septic shock, 3128 patients without AKI on admission are included. One-thousand-and-ninety-eight patients (35.1%) developed AKI within a median of 4.4 days. The median CVP levels and frequency of elevated CVP at 6, 12, 24, and 48 h are significantly higher in the AKI group. Elevated CVP (≥8 mmHg) at 6, 12, 24, and 48 h is associated with AKI incidence, even after adjusting for mean arterial pressure (MAP) levels. This association, after multivariable adjustments, only remains significant at 12 h with an odds ratio (OR) of 1.60 (95% CI, 1.26–2.05), p < 0.001 and 48 h with an OR of 1.60 (95% CI, 1.29–1.99), p < 0.001. Conclusions: Our findings indicate that CVP ≥ 8 mmHg is strongly associated with an increased risk of AKI, even after adjusting for MAP at the 12 and 48 h time points. These findings underscore a critical 12 or 48h window for interventions to lower CVP. Full article
(This article belongs to the Special Issue Acute Kidney Injury: Latest Advances and Prospects)
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18 pages, 3009 KiB  
Article
Influence of Baseline Kidney Function on Patient and Kidney Outcomes in Patients with COVID-19: A Multi-National Observational Study
by Harin Rhee, Etienne Macedo, Gary Cutter, Eric Judd, Sreejith Parameswaran, Elizabeth Maccariello, Wen-Jiun Liu, Nicholas M. Selby, Josée Bouchard, Guillermo Garcia-Garcia, Javier A. Neyra, Yadla Manjusha, Josephine Abraham, Kent Doi, Guillermo Villamizar, Abdias Hurtado and Ravindra L. Mehta
J. Clin. Med. 2025, 14(4), 1212; https://doi.org/10.3390/jcm14041212 - 12 Feb 2025
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Abstract
Background/Objectives: Acute kidney injury (AKI) is a common complication of coronavirus disease-19 (COVID-19), but the impact of baseline kidney function and care processes on outcomes is not well understood. We hypothesized that baseline kidney health status may influence courses and outcomes of [...] Read more.
Background/Objectives: Acute kidney injury (AKI) is a common complication of coronavirus disease-19 (COVID-19), but the impact of baseline kidney function and care processes on outcomes is not well understood. We hypothesized that baseline kidney health status may influence courses and outcomes of AKI. Methods: This is a multinational, multicenter, retrospective cohort study. We included hospitalized adult COVID-19 patients with kidney disease (AKI, end-stage kidney disease (ESKD), chronic kidney disease (CKD), or kidney transplant (KT) recipients) from 1 January 2020 to 31 March 2022, across 52 centers in 23 countries. Patients with no prior kidney function information were classified as acute kidney disease (AKD) if estimated glomerular filtration rate (eGFR) at admission was <60 mL/min/1.73 m2 and as no known kidney disease (NKD) if eGFR was ≥60 mL/min/1.73 m2. We defined combined outcome as death or non-kidney recovery at hospital discharge. Multivariable binary regression models were applied. Results: Among 4158 patients, 882 had ESKD, and 3038 developed AKI. AKI patients were categorized as NKD (31.8%), AKD (38.6%), CKD (23.3%), and KT recipients (3.3%). NKD patients had higher AKI severity and more intensive care unit care needs. In the multivariable analyses, the risk of the combined outcome was higher in AKD (OR 1.459 [1.061, 2.005]) or CKD (OR 1.705 [1.206, 2.410]) patients, although the risk of in-hospital mortality was similar to NKD. Among the survivors at hospital discharge, the risk of partial or non-recovery was higher in CKD (OR 5.445 [3.864, 7.672]) or KT recipients (OR 4.208 [2.383, 7.429]) compared to NKD. These findings were consistent across income categories. Conclusions: Among AKI patients with COVID-19, nearly two-thirds had underlying kidney dysfunction, with 55% identified as having baseline AKD, which had higher risk of death or non-kidney recovery at discharge compared to NKD. Full article
(This article belongs to the Special Issue Acute Kidney Injury: Latest Advances and Prospects)
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