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Acute Kidney Injury Due to Numerous Etiologies
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Acute Kidney Injury Due to Numerous Etiologies

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Nephrology & Urology".

Deadline for manuscript submissions: closed (31 August 2024) | Viewed by 6471

Special Issue Editor

Prof. Dr. Stanisław Niemczyk

E-Mail Website
Guest Editor
Department of Internal Medicine, Nephrology and Dialysis, Military Institute of Medicine, Szaserów Street 128, 04-141 Warsaw, Poland
Interests: nephrology; transplantology; endocrinology; geriatrics; hydration status; nutritional status; renal failure; ESRD; cardiovascular dysfunction; acute kidney injury; vasculitis; protein energy wasting; hormonal disorders in renal failure; hemodialysis; peritoneal dialysis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Acute kidney injury (AKI) is a serious, sometimes life-threatening, clinical complication. Although some causes of AKI are known, there are numerous states that may result in kidney injury. AKI may lead to chronic kidney disease, and in some cases, to end-stage renal disease with renal replacement therapy requirement. This Special Issue is aimed at presenting different causes of AKI, including injuries, surgical procedures, glomerulopathies, vasculitis, cardiovascular diseases, and others. It also aims to present cases of AKI related to multiple organ injuries due to mass events. The early treatment of AKI may prevent the development of chronic kidney disease and other complications of renal failure, which is why it is crucial to know about numerous causes of kidney injury and different methods of AKI treatment. A diverse range of articles included in this Special Issue would allow us to better understand the problem of AKI.

The topic should include:

  • AKI in septic shock
  • AKI in hypovolemic shock
  • AKI due to extensive injuries
  • AKI after numerous surgical procedures
  • AKI after cardiosurgical procedures
  • AKI related with numerous drug therapies
  • AKI after burn injury
  • AKI in multiple myeloma
  • Chronic kidney disease as a consequence of AKI
  • AKI in different glomerulopathies
  • Rapidly progressive glomerulonephritis in vasculitis
  • Plasmapheresis as a new method of AKI treatment due to vasculitis
  • Contrast-induced AKI
  • AKI in cardiorenal syndrome
  • AKI due to cardiovascular complications
  • AKI due to vascular complications
  • AKI in multiple organ failure due to mass events
  • Hemodialysis, hemodiafiltration and continuous renal replacement therapy

Prof. Dr. Stanisław Niemczyk
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • acute kidney injury
  • chronic kidney disease
  • cardiosurgical procedure
  • septic shock
  • hypovolemic shock
  • vasculitis
  • plasmapheresis
  • contrast-induced renal failure
  • cardiorenal syndrome
  • cardiovascular complications
  • vascular complications
  • multiple organ failure
  • hemodialysis
  • hemodiafiltration
  • renal replacement therapy

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Published Papers (5 papers)

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Research

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13 pages, 2909 KiB  
Article
Absolute Stenosis Measures of Renal Artery Independently Influence Kidney Perfusion in Contrast-Enhanced Multidetector Computed Tomography
by Arkadiusz Lubas, Arkadiusz Zegadło, Emilia Frankowska, Ewelina Jędrych, Tymoteusz Lubas, Anna Grzywacz, Ksymena Leśniak and Stanisław Niemczyk
J. Clin. Med. 2024, 13(17), 5022; https://doi.org/10.3390/jcm13175022 - 25 Aug 2024
Viewed by 691
Abstract
Background: A renal artery lumen reduction of ≥60% indicates hemodynamically significant stenosis and is one of the main criteria for invasive revascularization. We hypothesize that direct parameters describing renal artery stenosis (RAS) could better correlate with renal blood flow and improve the criterion [...] Read more.
Background: A renal artery lumen reduction of ≥60% indicates hemodynamically significant stenosis and is one of the main criteria for invasive revascularization. We hypothesize that direct parameters describing renal artery stenosis (RAS) could better correlate with renal blood flow and improve the criterion for revascularization. This study aimed to investigate RAS parameters independently associated with renal blood flow estimated in contrast-enhanced multidetector computed tomography (CE-MDCT). Methods: Ultrasound Doppler dynamic renal cortical perfusion (dRCP), CE-MDCT with cortical blood flow (CBF), and RAS assessment in the form of cross-sectional area reduction (CSAR), maximal diameter reduction (MaxDR), mean diameter (MeD), and minimal diameter (MinD) were investigated. Results: CBF correlated with CSAR (r = −0.422, p = 0.003), MeD (r = 0.344, p = 0.005) and MinD (r = 0.348, p= 0.005), whereas RCP correlated only with MeD (r = 0.357, p = 0.005) and MinD (r = 0.427, p< 0.001). In multivariable regression, only MeD was independently associated with CBF (R2 = 0.179; p < 0.001), and MeD < 3.5 mm substantially indicated CBF < 175 mL/100 g/min in ROC analysis. Conclusions: The directly measured mean diameter of RAS is independently associated with renal cortex blood flow and is probably a more appropriate parameter for the invasive RAS treatment criterion. Full article
(This article belongs to the Special Issue Acute Kidney Injury Due to Numerous Etiologies)
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10 pages, 602 KiB  
Article
Validation of a Prediction Model for Acute Kidney Injury after Cardiac Surgery in a Retrospective Asian Cohort
by Pei-Hsin Tsai, Jun-Sing Wang and Ching-Hui Shen
J. Clin. Med. 2024, 13(10), 2740; https://doi.org/10.3390/jcm13102740 - 7 May 2024
Viewed by 1025
Abstract
Background: The incidence of postoperative acute kidney injury (AKI) is relatively high in some Asian regions. The objective of this study was to examine the performance of an AKI prediction model developed based on data from a White-dominant population in a retrospective Asian [...] Read more.
Background: The incidence of postoperative acute kidney injury (AKI) is relatively high in some Asian regions. The objective of this study was to examine the performance of an AKI prediction model developed based on data from a White-dominant population in a retrospective Asian cohort of patients undergoing cardiovascular surgery. Methods: We retrospectively identified 549 patients who underwent elective major cardiovascular surgery (coronary artery bypass graft, valve surgery, and aorta surgery), and excluded those who underwent a percutaneous cardiovascular procedure. Patients with a baseline estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 were also excluded. AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) definition. Performance of the prediction model for AKI was expressed as area under the receiver operating characteristic curve (AUC). Results: The prediction model had a good predictive accuracy for postoperative AKI (all AUC > 0.92). The AUC of the prediction model in subgroups of age (<65 years and ≥65 years), sex (male and female), hypertension, and diabetes were all >0.85 (all p values < 0.001). Conclusions: The model could be used to predict postoperative AKI in Asian patients undergoing cardiovascular surgery with a baseline eGFR ≥ 60 mL/min/1.73 m2. Full article
(This article belongs to the Special Issue Acute Kidney Injury Due to Numerous Etiologies)
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12 pages, 1258 KiB  
Article
Assessment of Risk Factors for Acute Kidney Injury with Machine Learning Tools in Children Undergoing Hematopoietic Stem Cell Transplantation
by Kinga Musiał, Jakub Stojanowski, Monika Augustynowicz, Izabella Miśkiewicz-Migoń, Krzysztof Kałwak and Marek Ussowicz
J. Clin. Med. 2024, 13(8), 2266; https://doi.org/10.3390/jcm13082266 - 13 Apr 2024
Viewed by 1784
Abstract
Background: Although acute kidney injury (AKI) is a common complication in patients undergoing hematopoietic stem cell transplantation (HSCT), its prophylaxis remains a clinical challenge. Attempts at prevention or early diagnosis focus on various methods for the identification of factors influencing the incidence [...] Read more.
Background: Although acute kidney injury (AKI) is a common complication in patients undergoing hematopoietic stem cell transplantation (HSCT), its prophylaxis remains a clinical challenge. Attempts at prevention or early diagnosis focus on various methods for the identification of factors influencing the incidence of AKI. Our aim was to test the artificial intelligence (AI) potential in the construction of a model defining parameters predicting AKI development. Methods: The analysis covered the clinical data of children followed up for 6 months after HSCT. Kidney function was assessed before conditioning therapy, 24 h after HSCT, 1, 2, 3, 4, and 8 weeks after transplantation, and, finally, 3 and 6 months post-transplant. The type of donor, conditioning protocol, and complications were incorporated into the model. Results: A random forest classifier (RFC) labeled the 93 patients according to presence or absence of AKI. The RFC model revealed that the values of the estimated glomerular filtration rate (eGFR) before and just after HSCT, as well as methotrexate use, acute graft versus host disease (GvHD), and viral infection occurrence, were the major determinants of AKI incidence within the 6-month post-transplant observation period. Conclusions: Artificial intelligence seems a promising tool in predicting the potential risk of developing AKI, even before HSCT or just after the procedure. Full article
(This article belongs to the Special Issue Acute Kidney Injury Due to Numerous Etiologies)
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Review

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11 pages, 2928 KiB  
Review
Concept and Diagnostic Challenges of Renal-Limited Hemophagocytic Syndrome/Macrophage Activation Syndrome
by Takahiro Uchida and Takashi Oda
J. Clin. Med. 2024, 13(8), 2161; https://doi.org/10.3390/jcm13082161 - 9 Apr 2024
Viewed by 1106
Abstract
Hemophagocytic syndrome/macrophage activation syndrome (HPS/MAS) is a serious clinical condition that frequently leads to multiple organ failure, including acute kidney injury (AKI). Although the pathogenesis of AKI is not yet fully understood, it is believed to result from uncontrolled activation of the immune [...] Read more.
Hemophagocytic syndrome/macrophage activation syndrome (HPS/MAS) is a serious clinical condition that frequently leads to multiple organ failure, including acute kidney injury (AKI). Although the pathogenesis of AKI is not yet fully understood, it is believed to result from uncontrolled activation of the immune system involving macrophages and cytotoxic lymphocytes. Renal histology in HPS/MAS often presents with characteristic foamy glomerular lesions (glomerular lipidosis) with massive macrophage infiltration, known as histiocytic glomerulopathy. In this review, we introduce the recently proposed concept of renal-limited HPS/MAS as a novel etiology of histiocytic glomerular lipidosis. Patients with renal-limited HPS/MAS often develop AKI but do not fulfill the diagnostic criteria for HPS/MAS because their systemic manifestations are less severe. Therefore, the diagnosis largely depends on characteristic histological findings, that is, diffuse and global glomerular accumulation of foamy macrophages and cytotoxic lymphocytes accompanied by the interaction of these cells as well as the exclusion of various differential diseases. Although there are no established therapeutic regimens, these patients receive various types of therapies, including high-dose glucocorticoids, immunosuppressants, or anti-interleukin-1 drug, and generally achieve favorable outcomes. We summarized the concept, diagnostic challenges, and recent topics of this disease entity and discussed treatment options based on our own experiences. Full article
(This article belongs to the Special Issue Acute Kidney Injury Due to Numerous Etiologies)
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Other

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12 pages, 4463 KiB  
Case Report
Immunohistochemical Evaluation of Renal Biopsy with Anti-PD1 and p53 to Solve the Dilemma between Platinum- and Pembrolizumab-Induced AKI: Case Report and Review
by Nicoletta Mancianti, Sergio Antonio Tripodi, Alessandra Pascucci, Marta Calatroni, Edoardo La Porta, Andrea Guarnieri and Guido Garosi
J. Clin. Med. 2024, 13(7), 1828; https://doi.org/10.3390/jcm13071828 - 22 Mar 2024
Viewed by 1398
Abstract
Introduction: The combination therapy of platinum and pembrolizumab looks like a promising treatment in advanced non-small-cell lung cancer. However, both platinum-based chemotherapy and pembrolizumab can lead to AKI. AKI can occur due to acute tubular necrosis or interstitial nephritis. It is essential [...] Read more.
Introduction: The combination therapy of platinum and pembrolizumab looks like a promising treatment in advanced non-small-cell lung cancer. However, both platinum-based chemotherapy and pembrolizumab can lead to AKI. AKI can occur due to acute tubular necrosis or interstitial nephritis. It is essential to identify the drug responsible for renal damage. For this purpose, we used new immunohistochemistry markers (p53 and anti-PD1 analysis). Case Description: A 77-year-old female patient with advanced non-small-cell lung cancer received the PD-1 inhibitor pembrolizumab and platinum-based chemotherapy carboplatin. The patient, after 60 days, experienced AKI. A kidney biopsy was performed, and two new immunohistochemical techniques for p53 (experimental markers of ATN from platinum) and anti-PDL1 (experimental markers of PD-1 inhibitors nephritis) were employed. Renal biopsies revealed severe tubular damage. No infiltration was detected, and the immunohistochemical assessment of PDL-1 was negative. The expression of p53 was positive. The renal biopsy suggested platinum-induced acute tubular necrosis. After discontinuing steroids and reducing carboplatin, the patient continued with pembrolizumab, and their renal function returned to normal within two months. Discussion: Combining checkpoint inhibitors and platinum-based therapies may result in AKI. The standard method of examining kidney tissue may not provide sufficient information about the effects of these drugs on the kidneys. To address this issue, we recommend incorporating an assessment of the analysis of the expression of PDL1 and p53. This personalized approach will help identify the best treatment option for the patient while ensuring the best possible cancer treatment plan. Full article
(This article belongs to the Special Issue Acute Kidney Injury Due to Numerous Etiologies)
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