Pathophysiology of ischemic acute kidney injury

AA Sharfuddin, BA Molitoris - Nature Reviews Nephrology, 2011 - nature.com
AA Sharfuddin, BA Molitoris
Nature Reviews Nephrology, 2011nature.com
Acute kidney injury (AKI) as a consequence of ischemia is a common clinical event leading
to unacceptably high morbidity and mortality, development of chronic kidney disease (CKD),
and transition from pre-existing CKD to end-stage renal disease. Data indicate a close
interaction between the many cell types involved in the pathophysiology of ischemic AKI,
which has critical implications for the treatment of this condition. Inflammation seems to be
the common factor that links the various cell types involved in this process. In this Review …
Abstract
Acute kidney injury (AKI) as a consequence of ischemia is a common clinical event leading to unacceptably high morbidity and mortality, development of chronic kidney disease (CKD), and transition from pre-existing CKD to end-stage renal disease. Data indicate a close interaction between the many cell types involved in the pathophysiology of ischemic AKI, which has critical implications for the treatment of this condition. Inflammation seems to be the common factor that links the various cell types involved in this process. In this Review, we describe the interactions between these cells and their response to injury following ischemia. We relate these events to patients who are at high risk of AKI, and highlight the characteristics that might predispose these patients to injury. We also discuss how therapy targeting specific cell types can minimize the initial and subsequent injury following ischemia, thereby limiting the extent of acute changes and, hopefully, long-term structural and functional alterations to the kidney.
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