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A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
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Interventions for improving outcomes in acute kidney injury
Alexander Sarnowski1, James F Doyle2, Lui G Forni1,3
1Department of Intensive Care Medicine, Royal Surrey County Hospital NHS Foundation Trust, Guildford.
Current Opinion in Nephrology and Hypertension
|October 1, 2019
Summary
Recent advancements show that acute kidney injury (AKI) management can be improved with care bundles and specific therapies. Early identification and intervention offer hope for better patient outcomes in AKI.
Area of Science:
- Nephrology
- Critical Care Medicine
- Translational Medicine
Background:
- Acute kidney injury (AKI) classification is based on serum creatinine and urine output.
- Historically, a nihilistic approach prevailed, believing little could alter AKI's clinical course.
- The diverse causes of AKI suggested a 'one size fits all' management approach was unlikely to succeed.
Purpose of the Study:
- To review recent evidence on improving acute kidney injury management.
- To explore the potential of care bundles and novel therapeutics in AKI treatment.
- To challenge the traditional view that AKI management is largely unalterable.
Main Methods:
- Review of recent clinical evidence and therapeutic interventions for AKI.
- Analysis of the efficacy of standardized care bundles in intensive care settings.
- Evaluation of emerging specific therapies for AKI, including recombinant alkaline phosphatase, intravenous bicarbonate, and remote ischemic preconditioning.
Main Results:
- Evidence suggests that simple measures, like care bundles, can improve AKI management, especially in intensive care.
- Common treatments and novel specific therapies show promise in ameliorating AKI effects.
- Standardized care bundles, combined with specific therapies, appear promising for AKI management.
Conclusions:
- Management of acute kidney injury (AKI) can be improved with standardized care bundles.
- Specific therapies such as recombinant alkaline phosphatase, intravenous bicarbonate, and remote ischemic preconditioning may ameliorate AKI.
- A shift from a nihilistic approach to proactive management strategies is warranted for AKI.
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