Organ Crosstalk In Acute Kidney Injury

This is an original work dedicated to an important and current topic in nephrology: organ crosstalk in acute renal injury. Acute kidney injury is a prevalent and serious syndrome. The related mortality to this syndrome has not been significantly reduced in the last decades despite the advances in renal replacement therapy technology. For this reason, a new approach to obtain an effective treatment is urgently needed. The organ crosstalk perspective could be useful in order to achieve this objective since it implies a very early acute kidney injury diagnose and treatment. This book includes a comprehensive review of the organ crosstalk perspective in acute kidney injury. Organized in two parts, the chapters in the first part present general subjects as an introduction to analysing the crosstalk concept. These chapters give an overview of the concepts of biosemiotics, hormones, neurotransmitters, cytokines, signalling and adhesion molecules, organ intercommunication, and epigenetics. The second part gathers chapters on the different kidney crosstalk, such as brain, lung, heart, liver, gut, and placenta. Finally, there is a chapter dedicated to the influence of renal replacement treatment on kidney crosstalk. Since acute kidney injury is a topic of interest to many health professionals, this work will be a useful resource to general practitioners, internal medicine physicians, geriatricians, nephrologists, critical care therapists, immunologists, and also biologists and bioengineers.

Associated with both acute kidney injury (AKI) and cardio-renal syndromes (CRS), new biomarkers represent both a popular area of investigation and a new opportunity for advancement of therapy. This book contains the resolutions of the most recent ADQI conferences on biomarkers in AKI (Dublin) and on cardio-renal syndromes (Venice). The first part answers specific questions about new biomarkers and their use and utility in AKI: What are the most suitable candidate molecules and physiologic measures, how solid and evidence based is the discovery phase? How can we incorporate the new biomarkers in the AKI conceptual model describing the evolution from susceptibility to insult, decreased GFR and organ death? Even if we have a positive biomarker pattern and we can identify patients at risk or patients with early or even subclinical AKI, how is this information affecting our clinical behavior and practice? The second part is dedicated to the appraisal of the current knowledge about the pathophysiological mechanisms involved in different forms of CRS: it contains contributions on the state-of-the-art knowledge and practice of CRS, particularly focusing on the pathophysiology of the five subtypes. Acute and chronic mechanisms of damage are explored in depth, with particular attention to the primacy of organ involvement and the subsequent pathways of organ crosstalk.Presenting the most recent research in the field of biomarkers, AKI and CRS, this publication is an important educational tool for advanced investigators and clinical experts, but also for students and fellows.

A timely update Acute kidney injury (AKI) is a serious and as yet incompletely understood disorder in which sudden impairment of kidney function occurs secondary to one or more of a variety of underlying conditions. This disorder is very common in (elderly) ICU patients and is associated with very high mortality. Many of those who survive suffer from permanent kidney failure and other long-term morbidities, which may include cardiovascular disease and immune dysfunction. Epidemiologic evidence suggests that AKI is not a single disease, but a syndrome comprised of multiple, often coexisting, etiologies. Being usually part of multiorgan failure syndrome, it calls for multiple organ support therapy. The publication at hand contains sections on prerenal azotemia syndromes, dying of' or with' AKI, pathophysiology of sepsis- induced acute kidney injury, developments in prevention / treatment / rehabilitation, and renal support. Reporting the latest recommendations from experts, it provides valuable information for those that are interested in understanding the disorder and its treatment options.

This book presents up-to-date information on the clinical-pathophysiological features of acute renal injury and discusses the KDIGO diagnostic criteria, as well as novel experimental findings, including in the area of regenerative medicine. It also highlights the clinical-pathophysiological importance of AKI in clinical settings, including differential diagnoses and management of AKI. In the past, the pathology associated with sudden renal impairment was characterized as acute renal failure (ARF). However, in the 2000s, the joint efforts of specialists in fields including nephrology, intensive care medicine, and cardiovascular medicine led to the introduction of a novel concept known as acute kidney injury (AKI). As medical care progressed, patients such as high-risk elderly subjects who were not deemed to be candidates for invasive therapy came to be treated in intensive care units (ICUs). As a result, kidney injury as a subset of multiple organ failure was re-considered as AKI, especially in intensive care medicine. AKI was then proposed as a novel disease concept to emphasize the importance of early diagnosis and early intervention to improve prognosis.Presenting novel features, such as the definition of AKI, risk factors and management; biomarkers, such as neutrophil gelatinase-associated lipocalin (NGAL) and L-type fatty acid-binding protein (L-FABP); long-term outcomes of AKI; as well as renal regeneration using iPS cell, manipulation of embryonic genes, and Xenotransplanted embryonic kidney, this book is of interest to all physicians and researchers in this field around the globe.

Acute kidney injury is defined as an abrupt change in serum creatinine and/or urine output, and a majority of patients admitted to the ICU have some evidence of the disorder. Unfortunately, treatment for this complex syndrome is as yet lacking and understanding is limited. An interdisciplinary panel of experts has contributed to this volume, illuminating some of the fundamental and complex aspects of the disorder ranging from pathophysiology to treatment, from emerging biomarkers to genetic polymorphisms. Other contributions focus on immunological issues or the many complications of acute kidney injury and co-morbid conditions encountered, covering the fundamentals as well as the latest developments. Moreover, important technical aspects of extracorporeal therapies including vascular access, anticoagulation or fluid composition are introduced, and different approaches to renal support from intermittent dialysis to continuous therapies and hybrid techniques are discussed. A description of advanced extracorporeal techniques of organ support and their role in the management of sepsis and acute kidney injury in the context of an overall strategy of multi-organ failure management concludes the discussions. This volume not only provides a practical and up-to-date summary of current knowledge and technology, but also imparts a fundamental understanding of the pathogenesis and likely future developments in this field. It also serves to challenge and re-examine the fundamental underlying assumptions we hold regarding critical illness in general and acute kidney injury in particular.

This comprehensive guide covers the causes, characteristics, and presentations of acute kidney injury (AKI), as well as prevention and treatment. The first part of the book features chapters on the epidemiology and diagnosis of AKI. This is followed by sections on pathophysiology, clinical syndromes and patient management. Authored by leading clinicians, epidemiologists, basic scientists, and clinical trialists, this book captures the latest evidence and best practices for treating patients with AKI.