Acute kidney injury and chronic kidney disease: an integrated clinical syndrome.

Citation data:

Kidney international, ISSN: 1523-1755, Vol: 82, Issue: 5, Page: 516-24

Publication Year:
Usage 1637
Abstract Views 1042
Full Text Views 548
Link-outs 47
Captures 394
Readers 258
Exports-Saves 136
Mentions 1
Blog Mentions 1
Social Media 1
Tweets 1
Citations 291
Citation Indexes 291
Repository URL:
Chawla, Lakhmir S.; Kimmel, Paul L.
Elsevier BV
Medicine; Acute Kidney Injury--epidemiology; Kidney--physiopathology; Renal Insufficiency; Chronic--epidemiology; Acute Kidney Injury--epidemiology; Kidney--physiopathology; Renal Insufficiency; Chronic--epidemiology; Anesthesia and Analgesia
Most Recent Tweet View All Tweets
Most Recent Blog Mention
review description
The previous conventional wisdom that survivors of acute kidney injury (AKI) tend to do well and fully recover renal function appears to be flawed. AKI can cause end-stage renal disease (ESRD) directly, and increase the risk of developing incident chronic kidney disease (CKD) and worsening of underlying CKD. In addition, severity, duration, and frequency of AKI appear to be important predictors of poor patient outcomes. CKD is an important risk factor for the development and ascertainment of AKI. Experimental data support the clinical observations and the bidirectional nature of the relationships between AKI and CKD. Reductions in renal mass and nephron number, vascular insufficiency, cell cycle disruption, and maladaptive repair mechanisms appear to be important modulators of progression in patients with and without coexistent CKD. Distinction between AKI and CKD may be artificial. Consideration should be given to the integrated clinical syndrome of diminished GFR, with acute and chronic stages, where spectrum of disease state and outcome is determined by host factors, including the balance of adaptive and maladaptive repair mechanisms over time. Physicians must provide long-term follow-up to patients with first episodes of AKI, even if they presented with normal renal function.