title: Impact of acute kidney injury on distant organ function: recent findings and potential therapeutic targets.
abstract: Acute kidney injury (AKI) is a common complication in critically ill patients and subsequently worsens outcomes. Although many drugs to prevent and treat AKI have shown benefits in preclinical models, no specific agent has been shown to benefit AKI in humans. Moreover, despite remarkable advances in dialysis techniques that enable management of AKI in hemodynamically unstable patients with shock, dialysis-requiring severe AKI is still associated with an unacceptably high mortality rate. Thus, focusing only on kidney damage and loss of renal function has not been sufficient to improve outcomes of patients with AKI. Recent data from basic and clinical research have begun to elucidate complex organ interactions in AKI between kidney and distant organs, including heart, lung, spleen, brain, liver, and gut. This review serves to update the topic of organ cross talk in AKI and focuses on potential therapeutic targets to improve patient outcomes during AKI-associated multiple organ failure.
authors.affiliation: Department of Emergency and Critical Care Medicine, The University of Tokyo, Tokyo, Japan. Electronic address: kdoi-tky@umin.ac.jp.
authors.forename: Kent
authors.initials: K
authors.lastname: Doi
authors.affiliation: Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
authors.forename: Hamid
authors.initials: H
authors.lastname: Rabb
mesh_terms: D058186:Acute Kidney Injury / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D000818:Animals; D016638:Critical Illness; D006439:Hemodynamics; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D009102:Multiple Organ Failure / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D011379:Prognosis; D006435:Renal Dialysis; D012307:Risk Factors
keywords: acute kidney injury; inflammation; ischemia reperfusion; sepsis