Acute kidney disease: an overview of the epidemiology, pathophysiology, and management
Acute kidney injury (AKI) increases the risk of chronic kidney disease (CKD), and AKI and CKD are seen as interconnected syndromes. Acute kidney disease (AKD) is defined as subacute damage and/or loss of kidney function occurring 7 to 90 days after AKI, during which period key interventions may be i...
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| Format: | Article |
| Language: | English |
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The Korean Society of Nephrology
2023-11-01
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| Series: | Kidney Research and Clinical Practice |
| Subjects: | |
| Online Access: | http://krcp-ksn.org/upload/pdf/j-krcp-23-001.pdf |
| _version_ | 1797311443749568512 |
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| author | Chin-Wei Kung Yu-Hsiang Chou |
| author_facet | Chin-Wei Kung Yu-Hsiang Chou |
| author_sort | Chin-Wei Kung |
| collection | DOAJ |
| description | Acute kidney injury (AKI) increases the risk of chronic kidney disease (CKD), and AKI and CKD are seen as interconnected syndromes. Acute kidney disease (AKD) is defined as subacute damage and/or loss of kidney function occurring 7 to 90 days after AKI, during which period key interventions may be initiated to hinder the development of CKD. While AKD is usually under-recognized, it is associated with high morbidity and mortality globally. This review article aims to summarize the current knowledge concerning the epidemiology, pathophysiology, and management of AKD with the aim to develop monitoring strategies and therapeutic agents of AKD. Generally, AKD tends to occur more frequently in the elderly and those with chronic diseases, such as hypertension, diabetes mellitus, and metabolic syndrome. In addition, the severity, duration, and frequency of AKI are independent risk factors for AKD. Investigations of several mechanisms of AKD, such as renal tubular epithelium cell-cycle arrest, epigenetic change, chronic inflammation, mitochondria dysfunction, failed regeneration of tubular cells, metabolic reprogramming, and renin-angiotensin system (RAS) activation, have identified additional potential pharmacotherapy targets. Management of AKD includes prevention of repeated AKI, early and regular follow-up by a nephrologist, resumption and adjustment of essential medication, optimization of blood pressure control and nutrition management, and development of new pharmaceutical agents including RAS inhibitors. Finally, we outline a care bundle for AKD patients based on important lessons learned from studies and registries and identify the need for clinical trials of RAS inhibitors or other novel agents to impede ensuing CKD development. |
| first_indexed | 2024-03-08T01:59:42Z |
| format | Article |
| id | doaj.art-5cd6ed9e6b8e45b19f4db8617ca73c79 |
| institution | Directory Open Access Journal |
| issn | 2211-9132 2211-9140 |
| language | English |
| last_indexed | 2024-03-08T01:59:42Z |
| publishDate | 2023-11-01 |
| publisher | The Korean Society of Nephrology |
| record_format | Article |
| series | Kidney Research and Clinical Practice |
| spelling | doaj.art-5cd6ed9e6b8e45b19f4db8617ca73c792024-02-14T06:27:47ZengThe Korean Society of NephrologyKidney Research and Clinical Practice2211-91322211-91402023-11-0142668669910.23876/j.krcp.23.0016222Acute kidney disease: an overview of the epidemiology, pathophysiology, and managementChin-Wei Kung0Yu-Hsiang Chou1 Department of Internal Medicine, China Medical University Hospital, China Medical University College of Medicine, Taichung, Taiwan Renal Division, Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei City, TaiwanAcute kidney injury (AKI) increases the risk of chronic kidney disease (CKD), and AKI and CKD are seen as interconnected syndromes. Acute kidney disease (AKD) is defined as subacute damage and/or loss of kidney function occurring 7 to 90 days after AKI, during which period key interventions may be initiated to hinder the development of CKD. While AKD is usually under-recognized, it is associated with high morbidity and mortality globally. This review article aims to summarize the current knowledge concerning the epidemiology, pathophysiology, and management of AKD with the aim to develop monitoring strategies and therapeutic agents of AKD. Generally, AKD tends to occur more frequently in the elderly and those with chronic diseases, such as hypertension, diabetes mellitus, and metabolic syndrome. In addition, the severity, duration, and frequency of AKI are independent risk factors for AKD. Investigations of several mechanisms of AKD, such as renal tubular epithelium cell-cycle arrest, epigenetic change, chronic inflammation, mitochondria dysfunction, failed regeneration of tubular cells, metabolic reprogramming, and renin-angiotensin system (RAS) activation, have identified additional potential pharmacotherapy targets. Management of AKD includes prevention of repeated AKI, early and regular follow-up by a nephrologist, resumption and adjustment of essential medication, optimization of blood pressure control and nutrition management, and development of new pharmaceutical agents including RAS inhibitors. Finally, we outline a care bundle for AKD patients based on important lessons learned from studies and registries and identify the need for clinical trials of RAS inhibitors or other novel agents to impede ensuing CKD development.http://krcp-ksn.org/upload/pdf/j-krcp-23-001.pdfacute kidney diseaseacute kidney injuryaki-ckd continuumchronic kidney diseasesend-stage kidney disease |
| spellingShingle | Chin-Wei Kung Yu-Hsiang Chou Acute kidney disease: an overview of the epidemiology, pathophysiology, and management Kidney Research and Clinical Practice acute kidney disease acute kidney injury aki-ckd continuum chronic kidney diseases end-stage kidney disease |
| title | Acute kidney disease: an overview of the epidemiology, pathophysiology, and management |
| title_full | Acute kidney disease: an overview of the epidemiology, pathophysiology, and management |
| title_fullStr | Acute kidney disease: an overview of the epidemiology, pathophysiology, and management |
| title_full_unstemmed | Acute kidney disease: an overview of the epidemiology, pathophysiology, and management |
| title_short | Acute kidney disease: an overview of the epidemiology, pathophysiology, and management |
| title_sort | acute kidney disease an overview of the epidemiology pathophysiology and management |
| topic | acute kidney disease acute kidney injury aki-ckd continuum chronic kidney diseases end-stage kidney disease |
| url | http://krcp-ksn.org/upload/pdf/j-krcp-23-001.pdf |
| work_keys_str_mv | AT chinweikung acutekidneydiseaseanoverviewoftheepidemiologypathophysiologyandmanagement AT yuhsiangchou acutekidneydiseaseanoverviewoftheepidemiologypathophysiologyandmanagement |