Mechanistic Insights Into Acute Kidney Injury Complicating Invasive Pulmonary Aspergillosis in Adults

Invasive pulmonary aspergillosis (IPA) is a life-threatening fungal infection predominantly affecting immunocompromised patients, with a rising incidence observed in atypical hosts such as critically ill individuals. Acute kidney injury (AKI) represents a severe and frequent complication of IPA, markedly increasing morbidity and mortality rates. Despite its clinical significance, the pathophysiological mechanisms underlying IPA-associated AKI remain incompletely understood. This review provides a comprehensive examination of the multifactorial processes contributing to AKI in the context of IPA, including the direct nephrotoxic effects of fungal toxins, dysregulated host immune and inflammatory responses, drug-induced renal toxicity, and hemodynamic disturbances. By integrating recent advances from molecular biology, immunology, and clinical studies, we aim to elucidate the complex interplay of factors driving renal impairment in IPA patients. Understanding these mechanisms is crucial for the development of early diagnostic markers and targeted therapeutic strategies to improve patient outcomes. This comprehensive overview provides a theoretical foundation for future research and clinical management of IPA complicated by AKI.