Acute kidney injury in the critically ill: an updated review on pathophysiology and management.

Acute kidney injury Biomarkers Blood pressure management Diagnosis Fluid therapy Heterogeneity Long-term consequences Machine learning Nephrotoxicity Organ cross-talk Pathophysiology Phenotypes Vasopressor

Journal

Intensive care medicine
ISSN: 1432-1238
Titre abrégé: Intensive Care Med
Pays: United States
ID NLM: 7704851

Informations de publication

Date de publication:
Aug 2021
Historique:
received: 02 03 2021
accepted: 04 06 2021
pubmed: 3 7 2021
medline: 10 8 2021
entrez: 2 7 2021
Statut: ppublish

Résumé

Acute kidney injury (AKI) is now recognized as a heterogeneous syndrome that not only affects acute morbidity and mortality, but also a patient's long-term prognosis. In this narrative review, an update on various aspects of AKI in critically ill patients will be provided. Focus will be on prediction and early detection of AKI (e.g., the role of biomarkers to identify high-risk patients and the use of machine learning to predict AKI), aspects of pathophysiology and progress in the recognition of different phenotypes of AKI, as well as an update on nephrotoxicity and organ cross-talk. In addition, prevention of AKI (focusing on fluid management, kidney perfusion pressure, and the choice of vasopressor) and supportive treatment of AKI is discussed. Finally, post-AKI risk of long-term sequelae including incident or progression of chronic kidney disease, cardiovascular events and mortality, will be addressed.

Identifiants

pubmed: 34213593
doi: 10.1007/s00134-021-06454-7
pii: 10.1007/s00134-021-06454-7
pmc: PMC8249842
doi:

Substances chimiques

Biomarkers 0

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

835-850

Informations de copyright

© 2021. The Author(s).

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Auteurs

Peter Pickkers (P)

Department of Intensive Care, Radboud University Medical Centre, PO Box 9101, NL 6500 HB, Nijmegen, The Netherlands.

Michael Darmon (M)

APHP, Service de médecine intensive et de réanimation, Hôpital Saint-Louis, 1 avenue Claude Vellefaux, 75010, Paris, France.
Université de Paris, ECSTRA Team, UMR 1153, Center of Epidemiology and Biostatistics, INSERM, Paris, France.

Eric Hoste (E)

Department of Intensive Care Medicine, Ghent University Hospital, Ghent University, C. Heymanslaan 10, 9000, Ghent, Belgium.
Research Foundation-Flanders (FWO), Egmontstraat 5, 1000, Brussels, Belgium.

Michael Joannidis (M)

Division of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University of Innsbruck, Innsbruck, Austria.

Matthieu Legrand (M)

Department of Anesthesia and Peri-Operative Care, Division of Critical Care Medicine, University of California San Francisco, San Francisco, USA.

Marlies Ostermann (M)

Department of Critical Care, King's College London, Guy's & St Thomas' Hospital, London, SE1 9RT, UK.

John R Prowle (JR)

Adult Critical Care Unit, Department of Renal Medicine and Transplantation, The Royal London Hospital, Barts Health NHS Trust, London, UK.
William Harvey Research Institute, Queen Mary University of London, London, UK.

Antoine Schneider (A)

Adult Intensive Care Unit, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.

Miet Schetz (M)

Clinical Department and Laboratory of Intensive Care Medicine, Division of Cellular and Molecular Medicine, KU Leuven University, Herestraat 49, B3000, Leuven, Belgium. marie.schetz@uzleuven.be.

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