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Updated: May 28, 2026
A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
Renal angina: an emerging paradigm to identify children at risk for acute kidney injury
Rajit K Basu1, Lakhmir S Chawla, Derek S Wheeler
1Center for Acute Care Nephrology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA. Rajit.basu@cchmc.org
Insights
Predicting acute kidney injury (AKI) is challenging. Renal angina, combining patient risk factors and early kidney dysfunction, offers a new method to predict AKI progression and improve early treatment.
Area of Science:
- Nephrology
- Critical Care Medicine
- Biomarker Research
Background:
- Acute kidney injury (AKI) is a significant cause of morbidity and mortality.
- Current diagnostic methods for AKI are often reactive, lacking early predictive capabilities.
- Existing severity scoring systems do not effectively predict AKI development or progression.
Purpose of the Study:
- To introduce and highlight the concept of renal angina for predicting AKI progression.
- To address the limitations in early AKI diagnosis and prediction models.
- To improve the efficiency of biomarker-based AKI detection and facilitate early therapeutic interventions.
Main Methods:
- Review and synthesis of existing literature on AKI prediction and biomarkers.
- Introduction of the renal angina concept, defined by patient risk factors and subtle signs of AKI.
- Proposal of renal angina criteria to identify patients at risk for AKI progression.
Main Results:
- Renal angina serves as a predictive methodology for AKI progression.
- Fulfillment of renal angina criteria can enhance the efficacy of AKI biomarkers.
- This approach aids in the development of predictive scoring systems for AKI.
Conclusions:
- The renal angina concept provides a novel framework for proactive AKI prediction.
- Early identification of patients meeting renal angina criteria can lead to timely interventions.
- Implementing renal angina criteria is crucial for advancing AKI prediction and management strategies.
Abstract:
Acute kidney injury (AKI) leads to high rates of morbidity and independently increases mortality risk. Therapy for AKI is likely limited by the inability to reliably diagnose AKI in its early stages, and, importantly, small changes in serum creatinine may be associated with poor outcomes and severe AKI. Whereas AKI biomarker research seeks to identify more sensitive and timely indices of kidney dysfunction, AKI lacks physical signs and symptoms to trigger biomarker assessment in at-risk patients, limiting biomarker efficacy. Accurate models of AKI prediction are unavailable. Severity of illness (SOI) scoring systems and organ dysfunction scores (OD), which stratify patients by prediction of mortality risk, are AKI reactive, not predictive. Kidney-specific severity scores do not account for AKI progression, and stratification models of AKI severity are not predictive of AKI. Thus, there is a need for a kidney scoring system that can help predict the development of AKI. This review highlights the concept of renal angina, a combination of patient risk factors and subtle AKI, as a methodology to predict AKI progression. Fulfillment of renal angina criteria will improve the efficiency of AKI prediction by biomarkers, in turn expediting early therapy and assisting in creation of AKI-predictive scoring systems.
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