Management throughout the whole course of acute kidney injury_West China Medical Journal

Authors：

AI Zhen ^1,2 ,  CHEN Wei ^1,2

1. Department of Nephrology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, P. R. China;
2. NHC Key Laboratory of Clinical Nephrology (Sun Yat-sen University) and Guangdong Provincial Key Laboratory of Nephrology, Guangzhou, Guangdong 510080, P. R. China;

Corresponding author：

CHEN Wei, Email: chenwei99@mail.sysu.edu.cn

Keywords：

Acute kidney injury; risk factors; biomarkers; prevention; treatment

DOI：

10.7507/1002-0179.202206032

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

The high incidence and mortality of acute kidney injury (AKI) have brought great challenges to global health. In recent years, China has made some achievements in the epidemiology, risk factors and treatment of AKI. However, further prevention and treatment are still facing difficulties. Based on current new ideas and research progress, this paper summarized and analyzed the management throughout the whole course of AKI, including AKI risk assessment, early prevention, early identification, treatment and follow-up. The aim is to make Chinese nephrologists realize the focus of AKI prevention and treatment, standardize the management of AKI, and explore the prevention and treatment strategy suitable for AKI in China.

Citation： AI Zhen, CHEN Wei. Management throughout the whole course of acute kidney injury. West China Medical Journal, 2022, 37(7): 1070-1075. doi: 10.7507/1002-0179.202206032 Copy

1.	Mehta RL, Cerdá J, Burdmann EA, et al. International Society of Nephrology’s 0by25 initiative for acute kidney injury (zero preventable deaths by 2025): a human rights case for nephrology. Lancet, 2015, 385(9987): 2616-2643.
2.	Hoste EAJ, Kellum JA, Selby NM, et al. Global epidemiology and outcomes of acute kidney injury. Nat Rev Nephrol, 2018, 14(10): 607-625.
3.	Wang Y, Wang J, Su T, et al. Community-acquired acute kidney injury: a nationwide survey in China. Am J Kidney Dis, 2017, 69(5): 647-657.
4.	Xu X, Nie S, Liu Z, et al. Epidemiology and clinical correlates of AKI in Chinese hospitalized adults. Clin J Am Soc Nephrol, 2015, 10(9): 1510-1518.
5.	Yang L, Xing G, Wang L, et al. Acute kidney injury in China: a cross-sectional survey. Lancet, 2015, 386(10002): 1465-1471.
6.	Nie S, Feng Z, Tang L, et al. Risk factor analysis for AKI including laboratory indicators: a nationwide multicenter study of hospitalized patients. Kidney Blood Press Res, 2017, 42(5): 761-773.
7.	Kashani K, Macedo E, Burdmann EA, et al. Acute kidney injury risk assessment: differences and similarities between resource-limited and resource-rich countries. Kidney Int Rep, 2017, 2(4): 519-529.
8.	Goldstein SL, Mottes T, Simpson K, et al. A sustained quality improvement program reduces nephrotoxic medication-associated acute kidney injury. Kidney Int, 2016, 90(1): 212-221.
9.	Goldstein SL, Dahale D, Kirkendall ES, et al. A prospective multi-center quality improvement initiative (NINJA) indicates a reduction in nephrotoxic acute kidney injury in hospitalized children. Kidney Int, 2020, 97(3): 580-588.
10.	Kashani K, Rosner MH, Haase M, et al. Quality improvement goals for acute kidney injury. Clin J Am Soc Nephrol, 2019, 14(6): 941-953.
11.	Schunk SJ, Zarbock A, Meersch M, et al. Association between urinary dickkopf-3, acute kidney injury, and subsequent loss of kidney function in patients undergoing cardiac surgery: an observational cohort study. Lancet, 2019, 394(10197): 488-496.
12.	Meersch M, Schmidt C, Hoffmeier A, et al. Prevention of cardiac surgery-associated AKI by implementing the KDIGO guidelines in high risk patients identified by biomarkers: the PrevAKI randomized controlled trial. Intensive Care Med, 2017, 43(11): 1551-1561.
13.	Göcze I, Jauch D, Götz M, et al. Biomarker-guided Intervention to prevent acute kidney injury after major surgery: the prospective randomized BigpAK study. Ann Surg, 2018, 267(6): 1013-1020.
14.	Kidney disease:improving global outcomes (KDIGO) acute kidney injury work group. KDIGO clinical practice guideline for acute kidney injury. Kidney Int Suppl, 2012, 2(1): 1-138.
15.	Albert C, Zapf A, Haase M, et al. Neutrophil gelatinase-associated lipocalin measured on clinical laboratory platforms for the prediction of acute kidney injury and the associated need for dialysis therapy: a systematic review and meta-analysis. Am J Kidney Dis, 2020, 76(6): 826-841e1.
16.	Ho J, Tangri N, Komenda P, et al. Urinary, plasma, and serum biomarkers’ utility for predicting acute kidney injury associated with cardiac surgery in adults: a meta-analysis. Am J Kidney Dis, 2015, 66(6): 993-1005.
17.	Ostermann M, McCullough PA, Forni LG, et al. Kinetics of urinary cell cycle arrest markers for acute kidney injury following exposure to potential renal insults. Crit Care Med, 2018, 46(3): 375-383.
18.	Joannidis M, Forni LG, Haase M, et al. Use of cell cycle arrest biomarkers in conjunction with classical markers of acute kidney injury. Crit Care Med, 2019, 47(10): e820-e826.
19.	Fan PC, Chen CC, Peng CC, et al. A circulating miRNA signature for early diagnosis of acute kidney injury following acute myocardial infarction. J Transl Med, 2019, 17(1): 139.
20.	Ostermann M, Zarbock A, Goldstein S, et al. Recommendations on acute kidney injury biomarkers from the acute disease quality initiative consensus conference: a consensus statement. JAMA Netw Open, 2020, 3(10): e2019209.
21.	Dépret F, Hollinger A, Cariou A, et al. Incidence and outcome of subclinical acute kidney injury using penKid in critically ill patients. Am J Respir Crit Care Med, 2020, 202(6): 822-829.
22.	Moore PK, Hsu RK, Liu KD. Management of acute kidney injury: core curriculum 2018. Am J Kidney Dis, 2018, 72(1): 136-148.
23.	Finfer S, Micallef S, Hammond N, et al. Balanced multielectrolyte solution versus saline in critically ill adults. N Engl J Med, 2022, 386(9): 815-826.
24.	Lumlertgul N, Peerapornratana S, Trakarnvanich T, et al. Early versus standard initiation of renal replacement therapy in furosemide stress test non-responsive acute kidney injury patients (the FST trial). Crit Care, 2018, 22(1): 101.
25.	Zhao GJ, Xu C, Ying JC, et al. Association between furosemide administration and outcomes in critically ill patients with acute kidney injury. Crit Care, 2020, 24(1): 75.
26.	Liu C, Yan S, Wang Y, et al. Drug-induced hospital-acquired acute kidney injury in China: a multicenter cross-sectional survey. Kidney Dis (Basel), 2021, 7(2): 143-155.
27.	Perazella MA, Rosner MH. Drug-Induced Acute Kidney Injury. Clin J Am Soc Nephrol. (2022-03)[2022-06-01]. https://cjasn.asnjournals.org/content/early/2022/03/10/CJN.11290821.
28.	McDonald JS, McDonald RJ, Williamson EE, et al. Post-contrast acute kidney injury in intensive care unit patients: a propensity score-adjusted study. Intensive Care Med, 2017, 43(6): 774-784.
29.	Barbar SD, Clere-Jehl R, Bourredjem A, et al. Timing of renal-replacement therapy in patients with acute kidney injury and sepsis. N Engl J Med, 2018, 379(15): 1431-1442.
30.	Nieuwenhuijs-Moeke GJ, Sanders JSF. Timing of renal replacement therapy in acute kidney injury: case closed?. Lancet, 2020, 395(10235): 1465-1467.
31.	Gaudry S, Hajage D, Benichou N, et al. Delayed versus early initiation of renal replacement therapy for severe acute kidney injury: a systematic review and individual patient data meta-analysis of randomised clinical trials. Lancet, 2020, 395(10235): 1506-1515.
32.	Gaudry S, Hajage D, Martin-Lefevre L, et al. Comparison of two delayed strategies for renal replacement therapy initiation for severe acute kidney injury (AKIKI 2): a multicentre, open-label, randomised, controlled trial. Lancet, 2021, 397(10281): 1293-1300.
33.	Klein SJ, Brandtner AK, Lehner GF, et al. Biomarkers for prediction of renal replacement therapy in acute kidney injury: a systematic review and meta-analysis. Intensive Care Med, 2018, 44(3): 323-336.
34.	Bouchard J, Mehta RL. Timing of kidney support therapy in acute kidney injury: what are we waiting for?. Am J Kidney Dis, 2022, 79(3): 417-426.
35.	Gaudry S, Grolleau F, Barbar S, et al. Continuous renal replacement therapy versus intermittent hemodialysis as first modality for renal replacement therapy in severe acute kidney injury: a secondary analysis of AKIKI and IDEAL-ICU studies. Critical care, 2022, 26(1): 93.
36.	Cullis B, Al-Hwiesh A, Kilonzo K, et al. ISPD guidelines for peritoneal dialysis in acute kidney injury: 2020 update (adults). Perit Dial Int, 2021, 41(1): 15-31.
37.	Liu L, Zhang L, Liu GJ, et al. Peritoneal dialysis for acute kidney injury. Cochrane Database Syst Rev, 2017, 12(12): CD011457.
38.	Ostermann M, Bellomo R, Burdmann EA, et al. Controversies in acute kidney injury: conclusions from a kidney disease: improving global outcomes (KDIGO) conference. Kidney Int, 2020, 98(2): 294-309.
39.	Geo HN, Murugan DD, Chik Z, et al. Renal nano-drug delivery for acute kidney injury: current status and future perspectives. J Control Release, 2022, 343: 237-254.
40.	Chen Q, Ding F, Zhang S, et al. Sequential therapy of acute kidney injury with a DNA nanodevice. Nano Lett, 2021, 21(10): 4394-4402.
41.	Tang TT, Wang B, Li ZL, et al. Kim-1 targeted extracellular vesicles: a new therapeutic platform for RNAi to treat AKI. J Am Soc Nephrol, 2021, 32(10): 2467-2483.
42.	Park HJ, Kong MJ, Jang HJ, et al. A nonbiodegradable scaffold-free cell sheet of genome-engineered mesenchymal stem cells inhibits development of acute kidney injury. Kidney Int, 2021, 99(1): 117-133.
43.	Suzuki H, Ohtake T, Tsukiyama T, et al. Acute kidney injury successfully treated with autologous granulocyte colony-stimulating factor-mobilized peripheral blood CD34-positive cell transplantation: a first-in-human report. Stem Cells Transl Med, 2021, 10(9): 1253-1257.
44.	Hsu CY, Chinchilli VM, Coca S, et al. Post-acute kidney injury proteinuria and subsequent kidney disease progression: the assessment, serial evaluation, and subsequent sequelae in acute kidney injury (ASSESS-AKI) study. JAMA Intern Med, 2020, 180(3): 402-410.
45.	Wang Y, Gallagher M, Li Q, et al. Renal replacement therapy intensity for acute kidney injury and recovery to dialysis independence: a systematic review and individual patient data meta-analysis. Nephrol Dial Transplant, 2018, 33(6): 1017-1024.

1. Mehta RL, Cerdá J, Burdmann EA, et al. International Society of Nephrology’s 0by25 initiative for acute kidney injury (zero preventable deaths by 2025): a human rights case for nephrology. Lancet, 2015, 385(9987): 2616-2643.
2. Hoste EAJ, Kellum JA, Selby NM, et al. Global epidemiology and outcomes of acute kidney injury. Nat Rev Nephrol, 2018, 14(10): 607-625.
3. Wang Y, Wang J, Su T, et al. Community-acquired acute kidney injury: a nationwide survey in China. Am J Kidney Dis, 2017, 69(5): 647-657.
4. Xu X, Nie S, Liu Z, et al. Epidemiology and clinical correlates of AKI in Chinese hospitalized adults. Clin J Am Soc Nephrol, 2015, 10(9): 1510-1518.
5. Yang L, Xing G, Wang L, et al. Acute kidney injury in China: a cross-sectional survey. Lancet, 2015, 386(10002): 1465-1471.
6. Nie S, Feng Z, Tang L, et al. Risk factor analysis for AKI including laboratory indicators: a nationwide multicenter study of hospitalized patients. Kidney Blood Press Res, 2017, 42(5): 761-773.
7. Kashani K, Macedo E, Burdmann EA, et al. Acute kidney injury risk assessment: differences and similarities between resource-limited and resource-rich countries. Kidney Int Rep, 2017, 2(4): 519-529.
8. Goldstein SL, Mottes T, Simpson K, et al. A sustained quality improvement program reduces nephrotoxic medication-associated acute kidney injury. Kidney Int, 2016, 90(1): 212-221.
9. Goldstein SL, Dahale D, Kirkendall ES, et al. A prospective multi-center quality improvement initiative (NINJA) indicates a reduction in nephrotoxic acute kidney injury in hospitalized children. Kidney Int, 2020, 97(3): 580-588.
10. Kashani K, Rosner MH, Haase M, et al. Quality improvement goals for acute kidney injury. Clin J Am Soc Nephrol, 2019, 14(6): 941-953.
11. Schunk SJ, Zarbock A, Meersch M, et al. Association between urinary dickkopf-3, acute kidney injury, and subsequent loss of kidney function in patients undergoing cardiac surgery: an observational cohort study. Lancet, 2019, 394(10197): 488-496.
12. Meersch M, Schmidt C, Hoffmeier A, et al. Prevention of cardiac surgery-associated AKI by implementing the KDIGO guidelines in high risk patients identified by biomarkers: the PrevAKI randomized controlled trial. Intensive Care Med, 2017, 43(11): 1551-1561.
13. Göcze I, Jauch D, Götz M, et al. Biomarker-guided Intervention to prevent acute kidney injury after major surgery: the prospective randomized BigpAK study. Ann Surg, 2018, 267(6): 1013-1020.
14. Kidney disease:improving global outcomes (KDIGO) acute kidney injury work group. KDIGO clinical practice guideline for acute kidney injury. Kidney Int Suppl, 2012, 2(1): 1-138.
15. Albert C, Zapf A, Haase M, et al. Neutrophil gelatinase-associated lipocalin measured on clinical laboratory platforms for the prediction of acute kidney injury and the associated need for dialysis therapy: a systematic review and meta-analysis. Am J Kidney Dis, 2020, 76(6): 826-841e1.
16. Ho J, Tangri N, Komenda P, et al. Urinary, plasma, and serum biomarkers’ utility for predicting acute kidney injury associated with cardiac surgery in adults: a meta-analysis. Am J Kidney Dis, 2015, 66(6): 993-1005.
17. Ostermann M, McCullough PA, Forni LG, et al. Kinetics of urinary cell cycle arrest markers for acute kidney injury following exposure to potential renal insults. Crit Care Med, 2018, 46(3): 375-383.
18. Joannidis M, Forni LG, Haase M, et al. Use of cell cycle arrest biomarkers in conjunction with classical markers of acute kidney injury. Crit Care Med, 2019, 47(10): e820-e826.
19. Fan PC, Chen CC, Peng CC, et al. A circulating miRNA signature for early diagnosis of acute kidney injury following acute myocardial infarction. J Transl Med, 2019, 17(1): 139.
20. Ostermann M, Zarbock A, Goldstein S, et al. Recommendations on acute kidney injury biomarkers from the acute disease quality initiative consensus conference: a consensus statement. JAMA Netw Open, 2020, 3(10): e2019209.
21. Dépret F, Hollinger A, Cariou A, et al. Incidence and outcome of subclinical acute kidney injury using penKid in critically ill patients. Am J Respir Crit Care Med, 2020, 202(6): 822-829.
22. Moore PK, Hsu RK, Liu KD. Management of acute kidney injury: core curriculum 2018. Am J Kidney Dis, 2018, 72(1): 136-148.
23. Finfer S, Micallef S, Hammond N, et al. Balanced multielectrolyte solution versus saline in critically ill adults. N Engl J Med, 2022, 386(9): 815-826.
24. Lumlertgul N, Peerapornratana S, Trakarnvanich T, et al. Early versus standard initiation of renal replacement therapy in furosemide stress test non-responsive acute kidney injury patients (the FST trial). Crit Care, 2018, 22(1): 101.
25. Zhao GJ, Xu C, Ying JC, et al. Association between furosemide administration and outcomes in critically ill patients with acute kidney injury. Crit Care, 2020, 24(1): 75.
26. Liu C, Yan S, Wang Y, et al. Drug-induced hospital-acquired acute kidney injury in China: a multicenter cross-sectional survey. Kidney Dis (Basel), 2021, 7(2): 143-155.
27. Perazella MA, Rosner MH. Drug-Induced Acute Kidney Injury. Clin J Am Soc Nephrol. (2022-03)[2022-06-01]. https://cjasn.asnjournals.org/content/early/2022/03/10/CJN.11290821.
28. McDonald JS, McDonald RJ, Williamson EE, et al. Post-contrast acute kidney injury in intensive care unit patients: a propensity score-adjusted study. Intensive Care Med, 2017, 43(6): 774-784.
29. Barbar SD, Clere-Jehl R, Bourredjem A, et al. Timing of renal-replacement therapy in patients with acute kidney injury and sepsis. N Engl J Med, 2018, 379(15): 1431-1442.
30. Nieuwenhuijs-Moeke GJ, Sanders JSF. Timing of renal replacement therapy in acute kidney injury: case closed?. Lancet, 2020, 395(10235): 1465-1467.
31. Gaudry S, Hajage D, Benichou N, et al. Delayed versus early initiation of renal replacement therapy for severe acute kidney injury: a systematic review and individual patient data meta-analysis of randomised clinical trials. Lancet, 2020, 395(10235): 1506-1515.
32. Gaudry S, Hajage D, Martin-Lefevre L, et al. Comparison of two delayed strategies for renal replacement therapy initiation for severe acute kidney injury (AKIKI 2): a multicentre, open-label, randomised, controlled trial. Lancet, 2021, 397(10281): 1293-1300.
33. Klein SJ, Brandtner AK, Lehner GF, et al. Biomarkers for prediction of renal replacement therapy in acute kidney injury: a systematic review and meta-analysis. Intensive Care Med, 2018, 44(3): 323-336.
34. Bouchard J, Mehta RL. Timing of kidney support therapy in acute kidney injury: what are we waiting for?. Am J Kidney Dis, 2022, 79(3): 417-426.
35. Gaudry S, Grolleau F, Barbar S, et al. Continuous renal replacement therapy versus intermittent hemodialysis as first modality for renal replacement therapy in severe acute kidney injury: a secondary analysis of AKIKI and IDEAL-ICU studies. Critical care, 2022, 26(1): 93.
36. Cullis B, Al-Hwiesh A, Kilonzo K, et al. ISPD guidelines for peritoneal dialysis in acute kidney injury: 2020 update (adults). Perit Dial Int, 2021, 41(1): 15-31.
37. Liu L, Zhang L, Liu GJ, et al. Peritoneal dialysis for acute kidney injury. Cochrane Database Syst Rev, 2017, 12(12): CD011457.
38. Ostermann M, Bellomo R, Burdmann EA, et al. Controversies in acute kidney injury: conclusions from a kidney disease: improving global outcomes (KDIGO) conference. Kidney Int, 2020, 98(2): 294-309.
39. Geo HN, Murugan DD, Chik Z, et al. Renal nano-drug delivery for acute kidney injury: current status and future perspectives. J Control Release, 2022, 343: 237-254.
40. Chen Q, Ding F, Zhang S, et al. Sequential therapy of acute kidney injury with a DNA nanodevice. Nano Lett, 2021, 21(10): 4394-4402.
41. Tang TT, Wang B, Li ZL, et al. Kim-1 targeted extracellular vesicles: a new therapeutic platform for RNAi to treat AKI. J Am Soc Nephrol, 2021, 32(10): 2467-2483.
42. Park HJ, Kong MJ, Jang HJ, et al. A nonbiodegradable scaffold-free cell sheet of genome-engineered mesenchymal stem cells inhibits development of acute kidney injury. Kidney Int, 2021, 99(1): 117-133.
43. Suzuki H, Ohtake T, Tsukiyama T, et al. Acute kidney injury successfully treated with autologous granulocyte colony-stimulating factor-mobilized peripheral blood CD34-positive cell transplantation: a first-in-human report. Stem Cells Transl Med, 2021, 10(9): 1253-1257.
44. Hsu CY, Chinchilli VM, Coca S, et al. Post-acute kidney injury proteinuria and subsequent kidney disease progression: the assessment, serial evaluation, and subsequent sequelae in acute kidney injury (ASSESS-AKI) study. JAMA Intern Med, 2020, 180(3): 402-410.
45. Wang Y, Gallagher M, Li Q, et al. Renal replacement therapy intensity for acute kidney injury and recovery to dialysis independence: a systematic review and individual patient data meta-analysis. Nephrol Dial Transplant, 2018, 33(6): 1017-1024.

Previous Article
Informatization and artificial intelligence in continuous renal replacement therapy
Next Article
Research progress on renal tubular cell senescence in acute kidney injury

West China Medical Journal

Management throughout the whole course of acute kidney injury

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content