Delayed Consequences of Acute Kidney Injury.
Acute kidney injury (AKI) is an increasingly common complication of hospitalization and acute illness. Experimental data indicate that AKI may cause permanent kidney damage through tubulointerstitial fibrosis and progressive nephron loss, while also lowering the threshold for subsequent injury. Furthermore, preclinical data suggest that AKI may also cause distant organ dysfunction. The extension of these findings to human studies suggests long-term consequences of AKI including, but not limited to recurrent AKI, progressive kidney disease, elevated blood pressure, cardiovascular events, and mortality. As the number of AKI survivors increases, the need to better understand the mechanisms driving these processes becomes paramount. Optimizing care for AKI survivors will require understanding the short- and long-term risks associated with AKI, identifying patients at highest risk for poor outcomes, and testing interventions that target modifiable risk factors. In this review, we examine the literature describing the association between AKI and long-term outcomes and highlight opportunities for further research and potential intervention.
Tennessee Valley Healthcare System (TVHS), Geriatric Research Education and Clinical Centers (GRECC), Nashville, TN; TVHS, Veterans Administration (VA) Medical Center, Veterans Health Administration, Nashville, TN; Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN; and Vanderbilt Center for Kidney Disease (VCKD), Nashville, TN.
Sharidan K
SK
Parr
Tennessee Valley Healthcare System (TVHS), Geriatric Research Education and Clinical Centers (GRECC), Nashville, TN; TVHS, Veterans Administration (VA) Medical Center, Veterans Health Administration, Nashville, TN; Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN; and Vanderbilt Center for Kidney Disease (VCKD), Nashville, TN. Electronic address: edward.siew@vanderbilt.edu.
Edward D
ED
Siew
D058186:Acute Kidney Injury / Q000150:complications*; D002318:Cardiovascular Diseases / Q000209:etiology*; D018450:Disease Progression; D006760:Hospitalization; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000209:etiology*; D009026:Mortality; D012008:Recurrence; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000209:etiology*
Acute kidney injury (AKI); Chronic kidney disease (CKD); End-stage renal disease (ESRD); Mortality