scholarly journals Current Concepts of Pediatric Acute Kidney Injury—Are We Ready to Translate Them into Everyday Practice?

2021 ◽  
Vol 10 (14) ◽  
pp. 3113
Author(s):  
Kinga Musiał
Keyword(s):  
Acute Kidney Injury ◽  
Surrogate Marker ◽  
Kidney Injury ◽  
Tubuloglomerular Feedback ◽  
Everyday Practice ◽  
Special Focus ◽  
Functional Reserve ◽  
Renal Functional Reserve ◽  
Acute Kidney Disease ◽  
Pediatric Acute Kidney Injury

Pediatric acute kidney injury (AKI) is a major cause of morbidity and mortality in children undergoing interventional procedures. The review summarizes current classifications of AKI and acute kidney disease (AKD), as well as systematizes the knowledge on pathophysiology of kidney injury, with a special focus on renal functional reserve and tubuloglomerular feedback. The aim of this review is also to show the state-of-the-art in methods assessing risk and prognosis by discussing the potential role of risk stratification strategies, taking into account both glomerular function and clinical settings conditioned by fluid overload, urine output, or drug nephrotoxicity. The last task is to suggest careful assessment of eGFR as a surrogate marker of renal functional reserve and implementation of point-of-care testing, available in the case of biomarkers like NGAL and [IGFBP-7] × [TIMP-2] product, into everyday practice in patients at risk of AKI due to planned invasive procedures or treatment.

scholarly journals Renal Functional Reserve and Renal Recovery after Acute Kidney Injury

2014 ◽  
Vol 127 (1-4) ◽  
pp. 94-100 ◽  
Author(s):  
Aashish Sharma ◽  
Marìa Jimena Mucino ◽  
Claudio Ronco
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Renal Recovery ◽  
Functional Reserve ◽  
Renal Functional Reserve

scholarly journals Persistent decrease of renal functional reserve in patients after cardiac surgery-associated acute kidney injury despite clinical recovery

2018 ◽  
Vol 34 (2) ◽  
pp. 308-317 ◽  
Author(s):  
Faeq Husain-Syed ◽  
Fiorenza Ferrari ◽  
Aashish Sharma ◽  
Tommaso Hinna Danesi ◽  
Pércia Bezerra ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Kidney Injury ◽  
Functional Reserve ◽  
Renal Functional Reserve ◽  
Clinical Recovery

scholarly journals Preoperative Renal Functional Reserve Predicts Risk of Acute Kidney Injury After Cardiac Operation

2018 ◽  
Vol 105 (4) ◽  
pp. 1094-1101 ◽  
Author(s):  
Faeq Husain-Syed ◽  
Fiorenza Ferrari ◽  
Aashish Sharma ◽  
Tommaso Hinna Danesi ◽  
Pércia Bezerra ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Functional Reserve ◽  
Cardiac Operation ◽  
Renal Functional Reserve

Renal functional reserve: from physiological phenomenon to clinical biomarker and beyond

2020 ◽  
Vol 319 (6) ◽  
pp. R690-R702 ◽  
Author(s):  
Alemayehu H. Jufar ◽  
Yugeesh R. Lankadeva ◽  
Clive N. May ◽  
Andrew D. Cochrane ◽  
Rinaldo Bellomo ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Amino Acids ◽  
Acute Kidney Injury ◽  
Amino Acid ◽  
Kidney Disease ◽  
Kidney Injury ◽  
Functional Reserve ◽  
Acid Infusion ◽  
Amino Acid Infusion ◽  
Renal Functional Reserve

Glomerular filtration rate (GFR) is acutely increased following a high-protein meal or systemic infusion of amino acids. The mechanisms underlying this renal functional response remain to be fully elucidated. Nevertheless, they appear to culminate in preglomerular vasodilation. Inhibition of the tubuloglomerular feedback signal appears critical. However, nitric oxide, vasodilator prostaglandins, and glucagon also appear important. The increase in GFR during amino acid infusion reveals a “renal reserve,” which can be utilized when the physiological demand for single nephron GFR increases. This has led to the concept that in subclinical renal disease, before basal GFR begins to reduce, renal functional reserve can be recruited in a manner that preserves renal function. The extension of this concept is that once a decline in basal GFR can be detected, renal disease is already well progressed. This concept likely applies both in the contexts of chronic kidney disease and acute kidney injury. Critically, its corollary is that deficits in renal functional reserve have the potential to provide early detection of renal dysfunction before basal GFR is reduced. There is growing evidence that the renal response to infusion of amino acids can be used to identify patients at risk of developing either chronic kidney disease or acute kidney injury and as a treatment target for acute kidney injury. However, large multicenter clinical trials are required to test these propositions. A renewed effort to understand the renal physiology underlying the response to amino acid infusion is also warranted.

Renal C3 Production Drives Acute Kidney Injury and Acute Kidney Disease in Diabetics with Sepsis

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 1737-P
Author(s):  
LYNN M. FRYDRYCH ◽  
GUOWU BIAN ◽  
PETER A. WARD ◽  
MARKUS BITZER ◽  
MATTHEW DELANO
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Kidney Injury ◽  
Acute Kidney Disease
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