Chronic kidney disease following acute kidney injury-risk and outcomes

被引:175
作者
Leung, Kelvin C. W. [1 ]
Tonelli, Marcell [3 ]
James, Matthew T. [2 ]
机构
[1] Univ Calgary, Foothills Med Ctr, Dept Med, Calgary, AB T2N 2T9, Canada
[2] Univ Calgary, Foothills Med Ctr, Dept Community Hlth Sci, Calgary, AB T2N 2T9, Canada
[3] Univ Alberta, Dept Med, Edmonton, AB T6G 2G3, Canada
关键词
ACUTE-RENAL-FAILURE; SERUM CYSTATIN C; GLOMERULAR-FILTRATION-RATE; CARDIAC-SURGERY; POOR OUTCOMES; DIALYSIS; EXPRESSION; PROGRESSION; AKI; PROLIFERATION;
D O I
10.1038/nrneph.2012.280
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
In the past two decades, a substantial increase in the incidence of acute kidney injury (AKI) and kidney injury requiring dialysis has occurred in North America. This increase has coincided with an increase in the incidence of end-stage renal disease (ESRD), which has exceeded that expected based upon the prevalence of chronic kidney disease (CKD). In order to better understand the association between these conditions, there has been a proliferation of studies that have examined the risks of incident and progressive CKD following AKI. Animal studies have shown that failed differentiation of epithelial cells following renal ischaemia-reperfusion injury might lead to tubulointerstitial fibrosis, supporting a biological mechanism linking AKI and CKD. Strong and consistent associations between AKI and incident CKD, progression of CKD and incident ESRD have also been shown in epidemiological studies. In this Review, we summarize the wealth of available data on the relationship between AKI and CKD, and discuss the implications of these findings for the long-term clinical management of patients following AKI. We also identify areas of active investigation and future directions for research. Leung, K. C. W. et al. Nat. Rev. Nephrol. 9, 77-85 (2013); published online 18 December 2012; doi:10.1038/nrneph.2012.280
引用
收藏
页码:77 / 85
页数:9
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