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Related Concept Videos

Chronic Kidney Disease I: Introduction01:25

Chronic Kidney Disease I: Introduction

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Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
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Coronary Artery Disease I: Introduction01:30

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Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
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Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

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Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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Chronic Kidney Disease II: Clinical Manifestations01:24

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Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
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Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

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Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
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Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration01:28

Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration

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Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area.
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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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AKI: an increasingly recognized risk factor for CKD development and progression.

J T Kurzhagen1, S Dellepiane2, V Cantaluppi3

  • 1Division of Nephrology, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Ross 965, 720 Rutland Ave, Baltimore, MD, 21206, USA.

Journal of Nephrology
|July 12, 2020
PubMed
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Acute kidney injury (AKI) can lead to chronic kidney disease (CKD). Understanding AKI to CKD transition mechanisms is crucial for developing new treatments and preventing kidney fibrosis.

Keywords:
AKDAKICKDMechanismsRenal fibrosis

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Area of Science:

  • Nephrology
  • Pathophysiology
  • Translational Medicine

Background:

  • Acute kidney injury (AKI) presents a significant global health challenge, increasing morbidity and mortality.
  • AKI is a known risk factor for the development and progression of chronic kidney disease (CKD) and end-stage renal disease (ESRD).
  • Understanding the transition from AKI to CKD is critical for timely intervention and management.

Purpose of the Study:

  • To review the pathophysiological mechanisms underlying the progression from AKI to CKD.
  • To identify research gaps in the understanding of kidney fibrosis.
  • To discuss promising therapeutic strategies for mitigating AKI to CKD progression.

Main Methods:

  • Literature review of recent research on AKI pathophysiology.
  • Analysis of cellular and molecular mechanisms driving kidney fibrosis.
  • Examination of clinical efforts in AKI prevention and progression monitoring.

Main Results:

  • Maladaptive repair following AKI involves a complex interplay of cell death, endothelial dysfunction, tubular epithelial cell senescence, and inflammation, ultimately leading to fibrosis.
  • Numerous pathological mechanisms contributing to kidney fibrosis have been identified, highlighting potential therapeutic targets.
  • Advances in biomarkers and prediction models are aiding in AKI prevention and management.

Conclusions:

  • Elucidating the pathophysiology of AKI to CKD transition is essential for developing effective treatments.
  • Targeting fibrotic pathways offers a promising therapeutic avenue for preventing CKD progression after AKI.
  • Further research is needed to address current knowledge gaps and translate findings into clinical practice.