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Acute Kidney Injury to Chronic Kidney Disease: Pathophysiology and Therapy Targets 2.0

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A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Cell Biology and Pathology".

Deadline for manuscript submissions: closed (31 July 2023) | Viewed by 3821

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Special Issue Information

Dear Colleagues,

Acute kidney injury (AKI) is a complex heterogenous clinical syndrome with many different aetiologies, a broad range of clinical presentations, and varying trajectories and outcomes. Depending on the type of nephrotoxic insult, new biomarkers may be released concurrently: Severity, advice on metabolic medications (including more use of stain, anti-hypertension, anti-hyperglycemic agents, antiplatelet, and diuretics) during acute kidney disease periods, implementation of evidence-based chronic kidney disease therapy targets (including use of angiotensin converting enzyme inhibitors or angiotensin receptor blockers in the case of proteinuria, diabetes, and heart failure; diuretics in heart failure; statin in dyslipidemia) to decrease subsequent cardiovascular events, and close monitoring of various treatment options for other possible related issues, like sepsis and pneumonia.

The aims of this Special Issue are to better understand the complicated molecular pathways involved in AKI to CKD progression, including maladaptive alterations in tubular, interstitial, inflammatory, and vascular cells and, moreover, to better investigate the pathophysiology and therapy targets.

Dr. Yu-Wei Fang
Dr. Vin-Cent Wu
Guest Editors

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Keywords

acute kidney disease
acute kidney injury
biomarkers
molecular pathway
animal model
blood purification

Published Papers (2 papers)

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Research

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16 pages, 1631 KiB

Open AccessArticle

Serum Cystatin C Levels Could Predict Rapid Kidney Function Decline in A Community-Based Population

by Wei-Ching Fang, Hsing-Yu Chen, Shao-Chi Chu, Po-Hsi Wang, Chin-Chan Lee, I-Wen Wu, Chiao-Yin Sun, Heng-Jung Hsu, Chun-Yu Chen, Yung-Chang Chen, Vin-Cent Wu and Heng-Chih Pan

Biomedicines 2022, 10(11), 2789; https://0-doi-org.brum.beds.ac.uk/10.3390/biomedicines10112789 - 02 Nov 2022

Cited by 2 | Viewed by 2072

Abstract

Background: Several biomarkers have been correlated with the prevalence and severity of chronic kidney disease (CKD); however, the association between biomarkers and rapid kidney function decline (RKFD) is unknown. This study aimed to evaluate the predictive performance of biomarkers to determine who is likely to develop RKFD in a healthy population. Methods: A community-based cohort of 2608 people residing in northern Taiwan were enrolled, and their renal function was followed annually from January 2014 to December 2019. The outcomes of interest were RKFD, defined as a 15% decrease in the estimated glomerular filtration rate (eGFR) within the first 4 years, and a decrease in eGFR without improvement in the fifth year. Clinical variables and potential predictors of RKFD, namely adiponectin, leptin, tumor necrosis factor-alpha, and cystatin C, were measured and analyzed. Results: The incidence of RKFD was 17.0% (105/619). After matching for age and sex at a 1:1 ratio, a total of 200 subjects were included for analysis. The levels of cystatin C and total vitamin D were significantly negatively correlated with eGFR. eGFR was negatively correlated with the levels of cystatin C and total vitamin D. Among the biomarkers, cystatin C showed the best predictive performance for RKFD (area under the receiver operating characteristic curve: 0.789). Lower serum cystatin C was associated with a higher rate of RKFD in healthy subjects. A generalized additive model showed that 0.82 mg/L was an adequate cut-off value of cystatin C to predict RKFD. Multivariable logistic regression analysis further indicated that low cystatin C and eGFR were independent predictors of the possibility of RKFD. Conclusions: Serum cystatin C level could predict the possibility of RKFD. We suggest that a low cystatin C level should be considered as a risk factor for RKFD in healthy subjects. Full article

(This article belongs to the Special Issue Acute Kidney Injury to Chronic Kidney Disease: Pathophysiology and Therapy Targets 2.0)

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Review

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14 pages, 2149 KiB

Open AccessReview

Cardiovascular Consequences of Acute Kidney Injury: Treatment Options

by Julija G. Voicehovska, Dace Trumpika, Vladimirs V. Voicehovskis, Eva Bormane, Inara Bušmane, Anda Grigane, Eva Moreino and Aivars Lejnieks

Biomedicines 2023, 11(9), 2364; https://0-doi-org.brum.beds.ac.uk/10.3390/biomedicines11092364 - 24 Aug 2023

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Abstract

Soon after haemodialysis was introduced into clinical practice, a high risk of cardiac death was noted in end-stage renal disease. However, only in the last decade has it become clear that any renal injury, acute or chronic, is associated with high overall and cardiovascular lethality. The need for early recognition of kidney damage in cardiovascular pathology to assess risk and develop tactics for patient management contributed to the emergence of the concept of the “cardiorenal syndrome” (CRS). CRS is a pathophysiological disorder of the heart and kidneys in which acute or chronic dysfunction of one of these organs leads to acute or chronic dysfunction of the other. The beneficial effect of ultrafiltration as a component of renal replacement therapy (RRT) is due to the elimination of hyperhydration, which ultimately affects the improvement in cardiac contractile function. This review considers the theoretical background, current status of CRS, and future potential of RRT, focusing on the benefits of ultrafiltration as a therapeutic option. Full article

(This article belongs to the Special Issue Acute Kidney Injury to Chronic Kidney Disease: Pathophysiology and Therapy Targets 2.0)

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