title: Long-term remote organ consequences following acute kidney injury.
abstract: Acute kidney injury (AKI) has been a global health epidemic problem with soaring incidence, increased long-term risks for multiple comorbidities and mortality, as well as elevated medical costs. Despite the improvement of patient outcomes following the advancements in preventive and therapeutic strategies, the mortality rates among critically ill patients with AKI remain as high as 40-60 %. The distant organ injury, a direct consequence of deleterious systemic effects, following AKI is an important explanation for this phenomenon. To date, most evidence of remote organ injury in AKI is obtained from animal models. Whereas the observations in humans are from a limited number of participants in a relatively short follow-up period, or just focusing on the cytokine levels rather than clinical solid outcomes. The remote organ injury is caused with four underlying mechanisms: (1) "classical" pattern of acute uremic state; (2) inflammatory nature of the injured kidneys; (3) modulating effect of AKI of the underlying disease process; and (4) healthcare dilemma. While cytokines/chemokines, leukocyte extravasation, oxidative stress, and certain channel dysregulation are the pathways involving in the remote organ damage. In the current review, we summarized the data from experimental studies to clinical outcome studies in the field of organ crosstalk following AKI. Further, the long-term consequences of distant organ-system, including liver, heart, brain, lung, gut, bone, immune system, and malignancy following AKI with temporary dialysis were reviewed and discussed.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Saint Mary's Hospital Luodong, 160 Chong-Cheng South Road, Luodong, Yilan, 265, Taiwan.|Saint Mary's Medicine, Nursing and Management College, 160 Chong-Cheng South Road, Luodong, Yilan, 265, Taiwan.
authors.forename: Chih-Chung
authors.initials: CC
authors.lastname: Shiao
authors.affiliation: Division of Nephrology, Department of Internal Medicine, MacKay Memorial Hospital, 92, Sec. 2, Zhongshan N. Road, Taipei, 10449, Taiwan.
authors.forename: Pei-Chen
authors.initials: PC
authors.lastname: Wu
authors.affiliation: Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, 579, Sec. 2, Yunlin Road, Douliu City, Yunlin County, 640, Taiwan.
authors.forename: Tao-Min
authors.initials: TM
authors.lastname: Huang
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Bei-Hu Branch, 87 Neijiang Street, Taipei, 108, Taiwan.
authors.forename: Tai-Shuan
authors.initials: TS
authors.lastname: Lai
authors.affiliation: Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Hisn-Chu Branch, No.25, Lane 442, Sec. 1, Jingguo Road, Hsin-Chu City, 300, Taiwan.
authors.forename: Wei-Shun
authors.initials: WS
authors.lastname: Yang
authors.affiliation: Division of Nephrology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan.|School of Medicine, Tzu Chi University, Hualien, Taiwan.
authors.forename: Che-Hsiung
authors.initials: CH
authors.lastname: Wu
authors.affiliation: Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan South Road, Zhong-Zheng District, Taipei, 100, Taiwan.
authors.forename: Chun-Fu
authors.initials: CF
authors.lastname: Lai
authors.affiliation: Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan South Road, Zhong-Zheng District, Taipei, 100, Taiwan. q91421028@ntu.edu.tw.
authors.forename: Vin-Cent
authors.initials: VC
authors.lastname: Wu
authors.affiliation: Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan South Road, Zhong-Zheng District, Taipei, 100, Taiwan.
authors.forename: Tzong-Shinn
authors.initials: TS
authors.lastname: Chu
authors.affiliation: Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan South Road, Zhong-Zheng District, Taipei, 100, Taiwan.
authors.forename: Kwan-Dun
authors.initials: KD
authors.lastname: Wu
mesh_terms: D058186:Acute Kidney Injury / Q000150:complications* / Q000401:mortality / Q000503:physiopathology; D001921:Brain / Q000378:metabolism; D016638:Critical Illness / Q000401:mortality; D006321:Heart / Q000503:physiopathology; D006801:Humans; D007511:Ischemia / Q000503:physiopathology; D000069451:Long Term Adverse Effects / Q000401:mortality / Q000503:physiopathology*; D008168:Lung / Q000378:metabolism; D009102:Multiple Organ Failure / Q000209:etiology* / Q000503:physiopathology; D006435:Renal Dialysis / Q000009:adverse effects* / Q000401:mortality