Abstract
Acute kidney injury (AKI) is a known risk factor for chronic kidney disease (CKD) and end stage kidney disease (ESKD). The progression from AKI to CKD, despite being well recognised, is not completely understood, although sustained inflammation and fibrosis are implicated. A therapeutic intervention targeting the post AKI stage could reduce the progression to CKD, which has high levels of associated morbidity and mortality. Exercise has known anti-inflammatory effects with animal AKI models demonstrating its use as a therapeutic agent in abrogating renal injury. This suggests the use of an exercise rehabilitation programme in AKI patients following discharge could attenuate renal damage and improve long term patient outcomes. In this review article we outline considerations for future clinical studies of exercise in the AKI population.
Highlights
Acute kidney injury (AKI) is defined as a sudden decline in kidney function demonstrated by either a rise in serum creatinine of at least 50% over baseline levels occurring within a 7-day time period, or a sudden decrease in urine output [1]
It has been demonstrated that there is an increased risk of chronic kidney disease (CKD) and end stage kidney disease (ESKD) following AKI survival with the risk increasing in proportion to the severity of AKI [5]
Methods of AKI induction in animal models Animal models have used a range of methods to induce AKI, the most common being the administration of cisplatin, a known nephrotoxic drug [25–28] that is a widely used chemotherapy agent effective in the treatment of solid tumours [34]
Summary
Acute kidney injury (AKI) is defined as a sudden decline in kidney function demonstrated by either a rise in serum creatinine of at least 50% over baseline levels occurring within a 7-day time period, or a sudden decrease in urine output [1]. AKI occurs in 7–18% of patients in hospital, accounts for 50% of intensive care unit (ICU) admissions [2] and is responsible for 2 million deaths per year [3]. It is a complex condition with diffuse aetiologies resulting in both higher in-hospital and long-term mortality [4]. With adequate measures to reduce AKI risk, effective monitoring of patients, and with the implementation of appropriate interventions, the NHS could save up to £200 million a year [9]
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