Abstract
Acute kidney injury (AKI) has long-term biological effects on many organ systems and high mortality. Incomplete recovery of renal function from AKI is frequently observed, particularly when AKI is superimposed on chronic kidney disease (CKD), and this situation may further facilitate the progression of CKD. Patients with severe AKI in the intensive care unit typically have several failed extrarenal organ systems, including haemodynamic instability and respiratory failure. Consistent with these observations, AKI is associated with increased rates of graft failure and mortality after non-renal transplantation. For example, AKI is a common complication of liver transplantation and is associated with reduced patient and graft survival. AKI after lung transplantation also affects the clinical outcomes. The toxicity of calcineurin inhibitors, intraoperative hypoxemia, hypoperfusion due to diuretics overuse, and the use of antibiotics may be predisposing factors that leads to AKI after lung transplantation. While delayed graft function (DGF) caused by ischemic-reperfusion injury during the early phase of kidney transplantation affects graft function, pretransplantation AKI affecting donor kidneys may not have an adverse effect on long-term outcomes. Several biomarkers, such as gelatinase-associated lipocalin, have been evaluated for predicting DGF and long-term graft function; however, additional studies are required to establish the optimal use of these biomarkers. Recent studies also indicate that AKI during in the maintenance phase of kidney transplantation, frequently associated with sepsis and/or urinary tract infection, is a significant risk factor for graft failure. In this review, we focus on the impact of AKI on non-renal and renal transplant graft survival.
Highlights
Acute renal failure (ARF), termed acute kidney injury (AKI), was previously considered a reversible disease without long-term consequences
Ishani and colleagues found that elderly individuals with AKI, those previously diagnosed with chronic kidney disease (CKD), were at a significantly increased risk for end-stage renal disease (ESRD) [2]
These findings suggest that episodes of AKI may be a risk factor for the progression of renal disease
Summary
Acute renal failure (ARF), termed acute kidney injury (AKI), was previously considered a reversible disease without long-term consequences. Ishani and colleagues found that elderly individuals with AKI, those previously diagnosed with chronic kidney disease (CKD), were at a significantly increased risk for end-stage renal disease (ESRD) [2]. These findings suggest that episodes of AKI may be a risk factor for the progression of renal disease. It is not surprising that AKI is associated with increased rates of graft failure and mortality after non-renal transplantation. Xue and colleagues confirmed that severe AKI increased the long-term mortality risk after lung transplantation. A large multicentre randomised controlled trial may be required to define the role of inflammation in the occurrence AKI after cardiac surgeries
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Journal of Transplantation Technologies & Research
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
