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Management of Treatment and Prognosis in Acute Kidney Injury Patients

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

Deadline for manuscript submissions: closed (20 April 2023) | Viewed by 11613

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Special Issue Editors

Prof. Dr. Lili Zhou

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Guest Editor

Nanfang Hospital, Southern Medical University, Guangzhou, China
Interests: acute kidney injury; chronic kidney disease; renal fibrosis; senescence; Wnt/β-catenin signaling; renal immunology

Prof. Dr. Ying Tang

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Guest Editor

The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
Interests: acute kidney injuty; chronic kidney disease; renal fibrosis; mitochondria; podocytopathy.

Prof. Dr. Cheng Wang

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Guest Editor

The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China
Interests: diabetic kidney disease; virus-induced kidney disease; glomerulonephritis; podocyte biology and pathology; kidney failure

Special Issue Information

Dear Colleagues,

Acute kidney injury (AKI) is a worldwide public health problem associated with high morbidity and mortality. Moreover, AKI is now identified as a heterogeneous clinical syndrome that has multiple etiologies and variable pathogenesis. These heterogeneities affect the diagnosis and treatment of AKI. However, AKI is often still consid-ered to be a homogeneous clinical entity, which significantly impacts the application of suitable therapy and prog-nosis of AKI patients. On the other hand, the underlying mechanisms of AKI remain unclear. New drugs or thera-peutic strategies to improve AKI are still urgent needed. Therefore, efforts to illustrate the pathological mechanisms, develop the therapeutic approaches and improve the outcomes of different phenotypes of AKI will be appreciated. The heterogeneities of AKI not only affect treatment, but also a patient’s long-term prognosis. We hope this series of studies will stimulate investigators in related fields to strengthen their understanding of basic mechanisms, treatment, and prognosis in different phenotypes of AKI.

This Special Issue will publish a novel and exciting science which addresses the clinical management and fundamental mechanisms of AKI. The scope covers translational medicine research, new drug design, and clinical trials, new diagnostic methods, genetics analysis, cellular death and inflammation, signaling, and gene expression. The study of new technologies or materials is also welcomed. Studies should offer new insights into fundamental mechanisms and therapeutic strategies in AKI. We accept primary research papers, reviews, and commentaries. Short Takes about findings of exceptional relevance and interest in the related area are also welcomed.

Prof. Dr. Lili Zhou
Prof. Dr. Ying Tang
Prof. Dr. Cheng Wang
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
tumor immunotherapy
ischemia-reperfusion injury
kidney regeneration
cell death
mitochondria
metabolism

Published Papers (4 papers)

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Research

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12 pages, 1888 KiB

Open AccessArticle

Hypokalemia Duration in the First Year Associated with Subsequent Peritoneal Dialysis-Associated Peritonitis: A Multicenter Retrospective Cohort Study

by Zhihao Huo, Qianqian Zhuo, Shaoxin Zhong, Fang Wang, Chao Xie, Nirong Gong, Xiaohong Zhong, Zhixiu Yi, Yaozhong Kong, Dehui Liu, Xianrui Dou, Guobao Wang and Jun Ai

J. Clin. Med. 2022, 11(24), 7518; https://doi.org/10.3390/jcm11247518 - 19 Dec 2022

Cited by 1 | Viewed by 1275

Abstract

Background: The association of hypokalemia (LK) with peritoneal dialysis-associated peritonitis (PDAP) risk remains uncertain. Here, we calculated LK duration in the first PD year and evaluated its association with PDAP. Methods: A multicenter, retrospective, incident cohort study of 1633 participants was conducted from January 2008 to October 2020 in China. The duration of LK and severe hypokalemia (SLK) was calculated as the total number of months that a patient’s serum potassium (SK) level was less than 3.5 or 3.0 mEq/L during the first PD year. The study outcome was the risk of subsequent PDAP started in the second year and later. Cox proportional hazards models and competing risk models were used to assess the association. Results: The subsequent PDAP occurred in 420 (25.7%) participants during a median of 28 months of follow-up. Overall, LK duration in the first year was positively associated with a subsequent PDAP risk (per 3-month increments, adjusted HR, 1.13; 95%CI: 1.05–1.23). After categorization, patients with LK duration longer than 6 months had the highest adjusted HR of 1.53 (p = 0.005 vs. those without LK) for subsequent PDAP risk. A similar trend was also found for SLK duration. In a competing risk model, a similar trend was also observed. None of the variables, including demographic and PD characteristics, diabetes history, and several clinical measurements, significantly modified this association. The causative organisms of PDAP were similar to those previously reported. Conclusions: PD patients with longer LK duration in the first year had a higher subsequent PDAP risk. Full article

(This article belongs to the Special Issue Management of Treatment and Prognosis in Acute Kidney Injury Patients)

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12 pages, 1766 KiB

Open AccessArticle

Prognostic Value of Systemic Immune-Inflammation Index among Critically Ill Patients with Acute Kidney Injury: A Retrospective Cohort Study

by Lan Jia, Chen Li, Xueqing Bi, Fang Wei, Jia Meng, Guijiang Sun, Haibo Yu, Hongye Dong, Bo Li, Yueqi Cao, Lihua Wang and Aili Jiang

J. Clin. Med. 2022, 11(14), 3978; https://doi.org/10.3390/jcm11143978 - 8 Jul 2022

Cited by 8 | Viewed by 2477

Abstract

Inflammation plays a significant role in the occurrence and development of acute kidney injury (AKI). Evidence regarding the prognostic effect of the systemic immune-inflammation index (SII) in critically ill patients with AKI is scarce. The aim of this study was to assess the association between SII and all-cause mortality in these patients. Detailed clinical data were extracted from the Medical Information Mart for Intensive Care Database (MIMIC)-IV. The primary outcome was set as the in-hospital mortality. A total of 10,764 AKI patients were enrolled in this study. The restricted cubic splines analyses showed a J-shaped curve between SII and the risk of in-hospital and ICU mortality. After adjusting for relevant confounders, multivariate Cox regression analysis showed that both lower and higher SII levels were associated with an elevated risk of in-hospital all-cause mortality. A similar trend was observed for ICU mortality. In summary, we found that the SII was associated in a J-shaped pattern with all-cause mortality among critically ill patients with AKI. SII appears to be have potential applications in the clinical setting as a novel and easily accessible biomarker for predicting the prognosis of AKI patients. Full article

(This article belongs to the Special Issue Management of Treatment and Prognosis in Acute Kidney Injury Patients)

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Review

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13 pages, 679 KiB

Open AccessReview

Comprehensive Management of Blood Pressure in Patients with Septic AKI

by Junhui Deng, Lina Li, Yuanjun Feng and Jurong Yang

J. Clin. Med. 2023, 12(3), 1018; https://doi.org/10.3390/jcm12031018 - 28 Jan 2023

Cited by 2 | Viewed by 2642

Abstract

Acute kidney injury (AKI) is one of the serious complications of sepsis in clinical practice, and is an important cause of prolonged hospitalization, death, increased medical costs, and a huge medical burden to society. The pathogenesis of AKI associated with sepsis is relatively complex and includes hemodynamic abnormalities due to inflammatory response, oxidative stress, and shock, which subsequently cause a decrease in renal perfusion pressure and eventually lead to ischemia and hypoxia in renal tissue. Active clinical correction of hypotension can effectively improve renal microcirculatory disorders and promote the recovery of renal function. Furthermore, it has been found that in patients with a previous history of hypertension, small changes in blood pressure may be even more deleterious for kidney function. Therefore, the management of blood pressure in patients with sepsis-related AKI will directly affect the short-term and long-term renal function prognosis. This review summarizes the pathophysiological mechanisms of microcirculatory disorders affecting renal function, fluid management, vasopressor, the clinical blood pressure target, and kidney replacement therapy to provide a reference for the clinical management of sepsis-related AKI, thereby promoting the recovery of renal function for the purpose of improving patient prognosis. Full article

(This article belongs to the Special Issue Management of Treatment and Prognosis in Acute Kidney Injury Patients)

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25 pages, 1738 KiB

Open AccessReview

Organ Crosstalk in Acute Kidney Injury: Evidence and Mechanisms

by Xiaolong Li, Feifei Yuan and Lili Zhou

J. Clin. Med. 2022, 11(22), 6637; https://doi.org/10.3390/jcm11226637 - 9 Nov 2022

Cited by 8 | Viewed by 4504

Abstract

Acute kidney injury (AKI) is becoming a public health problem worldwide. AKI is usually considered a complication of lung, heart, liver, gut, and brain disease, but recent findings have supported that injured kidney can also cause dysfunction of other organs, suggesting organ crosstalk existence in AKI. However, the organ crosstalk in AKI and the underlying mechanisms have not been broadly reviewed or fully investigated. In this review, we summarize recent clinical and laboratory findings of organ crosstalk in AKI and highlight the related molecular mechanisms. Moreover, their crosstalk involves inflammatory and immune responses, hemodynamic change, fluid homeostasis, hormone secretion, nerve reflex regulation, uremic toxin, and oxidative stress. Our review provides important clues for the intervention for AKI and investigates important therapeutic potential from a new perspective. Full article

(This article belongs to the Special Issue Management of Treatment and Prognosis in Acute Kidney Injury Patients)

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