Acute kidney injury in kidney transplantation.
OBJECTIVE
Acute kidney injury (AKI) in transplant recipients is a prevalent condition with a broad list of potential inciting causes. This review highlights recent data describing the epidemiology and long-term consequences of transplant AKI, novel interventions in the management of delayed graft function (DGF), and noninvasive diagnostic strategies.


RESULTS
The incidence and outcomes of nontransplant AKI are well documented, and similar data are emerging in the transplant setting with recent reports suggesting a high incidence rate and significant impact on long-term graft outcomes. DGF represents a 'pure' form of transplant AKI, and many interventional trials aiming to limit ischemia-reperfusion-induced injury have recently been reported or are currently ongoing. The search for accurate noninvasive predictors of DGF and acute rejection is ongoing and recent literature describes novel plasma and urine-based biomarkers as well as transcriptional profiling methods with high potential for clinical applicability.


CONCLUSIONS
AKI in transplant recipients is a frequent occurrence with significant potential for poor long-term graft outcomes. Recent efforts to limit ischemia-reperfusion injury and diagnose transplant AKI via noninvasive methods may help to minimize the impact of AKI on future graft function.
Division of Renal Diseases and Hypertension, Transplant Center, University of Colorado Denver, Aurora, Colorado, USA.
James E
JE
Cooper
Alexander C
AC
Wiseman
D058186:Acute Kidney Injury / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D015415:Biomarkers / Q000032:analysis; D051799:Delayed Graft Function / Q000175:diagnosis / Q000209:etiology; D046148:Donor Selection; D020869:Gene Expression Profiling; D006084:Graft Rejection / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D020858:Tissue and Organ Harvesting
D015415:Biomarkers