New Insights into Chronic Kidney Disease and Acute Kidney Injury

Recent advances in nephrology have significantly improved the diagnosis and treatment of chronic kidney disease (CKD) and acute kidney injury (AKI). CKD affects about 10–15% of the global adult population, while AKI occurs in 10–20% of hospitalized patients and up to 50% of those in intensive care units, making both conditions major contributors to morbidity and mortality.

Diagnostic strategies should focus on the early detection of CKD and the early introduction of nephroprotective strategies and treatment. Comorbidities such as diabetes, hypertension, environmental factors, and multiple therapeutic agents used in oncology and hematology significantly influence kidney function and can cause acute or chronic renal impairment. Progress in imaging techniques and machine learning-based predictive models enhances monitoring and risk stratification.

Therapeutically, sodium–glucose co-transporter-2 (SGLT2) inhibitors have transformed CKD care by slowing progression and lowering cardiovascular risk. Novel mineralocorticoid receptor antagonists and glucagon-like peptide 1 receptor agonists improve renal outcomes in diabetic kidney disease. In AKI, early detection, hemodynamic optimization, and improved dialysis modalities remain central.

In glomerulonephritis (GN) and autoimmune kidney diseases such as lupus nephritis and ANCA-associated vasculitis, treatment is moving toward targeted immunotherapy. Monoclonal antibodies, including rituximab and other anti-CD20 antibodies, are increasingly used, enabling a reduction in steroid exposure. Complement inhibitors improved the therapeutic outcomes in thrombotic microangiopathies and ANCA-associated vasculitis and show promise in IgA nephropathy and C3 glomerulopathy. Advances in understanding autoimmune mechanisms have enabled more precise and less toxic interventions.

Kidney transplantation remains the best therapy for end-stage renal disease, with improvements in immunosuppression and donor matching enhancing graft survival. However, organ shortages continue to pose significant challenges.

This Special Issue, titled “New insights in chronic kidney disease and acute kidney injury”, welcomes submissions related to the topics described above.

Dr. Aleksandra Rymarz
Prof. Dr. Jolanta Małyszko
Guest Editors

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