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Life
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Acute Kidney Events in Intensive Care
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Acute Kidney Events in Intensive Care

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: 30 June 2025 | Viewed by 2035

Special Issue Editor

Dr. Silvia De Rosa

E-Mail Website
Guest Editor
Centre for Medical Sciences—CISMed, University of Trento, Via S. Maria Maddalena 1, 38122 Trento, Italy
Interests: acute brain injury; acute kidney injury; blood purification in sepsis; airway management; infectious disease; extracorporeal organ support; nutrition and metabolism in critical care
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

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.

This Special Issue’s purpose is to explore the advances in acute kidney events in intensive care, focusing on perspectives of interest from both a clinical perspective and for the scientific community.

Dr. Silvia De Rosa
Guest Editor

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. Life is an international peer-reviewed open access monthly 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 events
  • ICU
  • critically ill
  • RRT
  • outcome
  • acute kidney disease
  • chronic kidney disease
  • biomarkers

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Published Papers (2 papers)

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Research

11 pages, 736 KiB  
Article
Early Urine Output in the Emergency Room as a Prognostic Indicator for Critically Ill Patients Undergoing Continuous Renal Replacement
by Soo Hyun Han, Changshin Kang, Hyerim Park, Eu Jin Lee, Young Rok Ham, Ki Ryang Na, Jung Soo Park and Dae Eun Choi
Life 2025, 15(6), 866; https://doi.org/10.3390/life15060866 - 27 May 2025
Viewed by 252
Abstract
Objectives: The impact of initial emergency room (ER) factors on survival and renal function in critically ill patients undergoing continuous renal replacement therapy (CRRT) remains unclear. This study aimed to evaluate whether these initial factors influence survival and renal recovery in such patients. [...] Read more.
Objectives: The impact of initial emergency room (ER) factors on survival and renal function in critically ill patients undergoing continuous renal replacement therapy (CRRT) remains unclear. This study aimed to evaluate whether these initial factors influence survival and renal recovery in such patients. Methods: This single-center, retrospective study included 190 critically ill patients admitted to the intensive care unit (ICU) via the ER for CRRT between 1 March 2018, and 31 May 2021. Clinical parameters, including urine output, estimated glomerular filtration rate (eGFR), and serum neutrophil gelatinase-associated lipocalin (NGAL), were assessed. The primary outcomes were 30-day and 90-day mortality, while secondary outcomes included 30-day and 90-day RRT-free durations. Results: Patients with low urine output (LUO, defined as the average of <0.5 mL/kg/h over 6 h) were significantly associated with higher 30-day and 90-day mortality rates. Multivariable Cox regression analysis revealed that the LUO group had an increased risk of 30-day and 90-day mortality (hazard ratios: 1.935 and 2.141, respectively) compared to the high urine output (HUO, defined as the average of ≥0.5 mL/kg/h over 6 h) group. No significant association was observed between mortality and initial eGFR or plasma NGAL levels. However, the HUO group and patients with initial eGFR ≥ 30 mL/min/1.73 m2 had longer RRT-free durations at 30 and 90 days. Plasma NGAL levels did not significantly correlate with RRT-free durations. Conclusions: Initial 6-h urine output in the ER is a significant predictor of 30-day and 90-day mortality in critically ill patients undergoing CRRT. Full article
(This article belongs to the Special Issue Acute Kidney Events in Intensive Care)
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16 pages, 1261 KiB  
Article
Acute Kidney Injury in Patients After Cardiac Arrest: Effects of Targeted Temperature Management
by Silvia De Rosa, Sergio Lassola, Federico Visconti, Massimo De Cal, Lucia Cattin, Veronica Rizzello, Antonella Lampariello, Marina Zannato, Vinicio Danzi and Stefano Marcante
Life 2025, 15(2), 265; https://doi.org/10.3390/life15020265 - 10 Feb 2025
Viewed by 991
Abstract
Background: Cardiac arrest (CA) is a leading cause of mortality and morbidity, with survivors often developing post-cardiac arrest syndrome (PCAS), characterized by systemic inflammation, ischemia–reperfusion injury (IRI), and multiorgan dysfunction. Acute kidney injury (AKI), a frequent complication, is associated with increased mortality and [...] Read more.
Background: Cardiac arrest (CA) is a leading cause of mortality and morbidity, with survivors often developing post-cardiac arrest syndrome (PCAS), characterized by systemic inflammation, ischemia–reperfusion injury (IRI), and multiorgan dysfunction. Acute kidney injury (AKI), a frequent complication, is associated with increased mortality and prolonged intensive care unit (ICU) stays. This study evaluates AKI incidence and progression in cardiac arrest patients managed with different temperature protocols and explores urinary biomarkers’ predictive value for AKI risk. Methods: A prospective, single-center observational study was conducted, including patients with Return of Spontaneous Circulation (ROSC) post-cardiac arrest. Patients were stratified into three groups: therapeutic hypothermia (TH) at 33 °C, Targeted Temperature Management (TTM) at 35 °C, and no temperature management (No TTM). AKI was defined using KDIGO criteria, with serum creatinine and urinary biomarkers (TIMP-2 and IGFBP7) measured at regular intervals during ICU stay. Results: AKI incidence at 72 h was 31%, varying across protocols. It was higher in the No TTM group at 24 h and in the TH and TTM groups during rewarming. Persistent serum creatinine elevation and fluid imbalance were notable in the TH group. Biomarkers indicated moderate tubular stress in the TTM and No TTM groups. Conclusions: AKI is a frequent complication post-cardiac arrest, with the rewarming phase identified as critical for renal vulnerability. Tailored renal monitoring, biomarker-guided risk assessment, and precise temperature protocols are essential to improve outcomes. Full article
(This article belongs to the Special Issue Acute Kidney Events in Intensive Care)
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