The strategies of prevention and treatment of acute kidney injury in China_West China Medical Journal

Authors：

FENG Zhe ,  CHEN Xiangmei

Department of Nephrology, Chinese People’s Liberation Army General Hospital, Chinese People’s Liberation Army Institute of Nephrology, State Key Laboratory of Kidney Diseases (2011DAV00088), National Clinical Research Center for Kidney Diseases, Beijing 100853, P. R. China;

Corresponding author：

CHEN Xiangmei, Email: xmchen301@126.com

Keywords：

Acute kidney injury; Biomarkers; Renal replacement therapy; Treatment strategies

DOI：

10.7507/1002-0179.201806095

Video：

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Abstract Full text Figures/Tables Video References Cited by

Acute kidney injury (AKI), as a complex and severe kidney disease, has always been the hotspot of research. The epidemiological research of AKI in China has made significant progress, including initially reports on the domestic incidence of AKI, geographical distribution and risk factors; however, accompanying challenges like AKI prevention and treatment emerge. For improvement of the diagnosis and treatment of the AKI, this article summarizes and analyses the two challenges: early warning biomarkers and AKI treatment strategies, based on new ideas and research progress. The aim is to make Chinese nephrology scholars and specialists realize the focus of AKI prevention and protection of renal function, to standardize the treatment strategy of AKI, and to put forward the direction of future research.

Citation： FENG Zhe, CHEN Xiangmei. The strategies of prevention and treatment of acute kidney injury in China. West China Medical Journal, 2018, 33(7): 777-781. doi: 10.7507/1002-0179.201806095 Copy

1.	Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO clinical practice guideline for acute kidney injury. Kidney Int Suppl, 2012, 2(1): 1-138.
2.	Mehta RL, Cerdá J, Burdmann EA, et al. International society of nephrology's 0 by 25 initiative for acute kidney injury (zero preventable deaths by 2025): a human rights case for nephrology. Lancet, 2015, 385(9987): 2616-2643.
3.	Yang L, Xing G, Wang L, et al. Acute kidney injury in China: a cross-sectional survey. Lancet, 2015, 386(12): 1465-1471.
4.	Nie S, Feng Z, Tang L, et al. Risk factor analysis for AKI including laboratory indicators: a nationwide multicenter study of hospitalized patients. Kidney Blood Press Res, 2017, 42(5): 761-773.
5.	Beker BM, Corleto MG, Fieiras C, et al. Novel acute kidney injury biomarkers: their characteristics, utility and concerns. Int Urol Nephrol, 2018, 50(4): 705-713.
6.	Alge JL, Arthur JM. Biomarkers of AKI: a review of mechanistic relevance and potential therapeutic implications. Clin J Am Soc Nephrol, 2015, 10(1): 147-155.
7.	Murray PT, Mehta RL, Shaw A, et al. Potential use of biomarkers in acute kidney injury: report and summary of recommendations from the 10th Acute Dialysis Quality Initiative Consensus Conference. Kidney Int, 2014, 85(3): 513-521.
8.	Wierstra BT, Kadri S, Alomar S, et al. The impact of "early" versus "late" initiation of renal replacement therapy in critical care patients with acute kidney injury: a systematic review and evidence synthesis. Crit Care, 2016, 20(1): 122.
9.	Wald R, Adhikari NK, Smith OM, et al. Comparison of standard and accelerated initiation of renal replacement therapy in acute kidney injury. Kidney Int, 2015, 88(4): 897-904.
10.	Gaudry S, Hajage D, Schortgen F, et al. Initiation strategies for renal-replacement therapy in the intensive care unit. N Engl J Med, 2016, 375(2): 122-133.
11.	Zarbock A, Kellum JA, Schmidt C, et al. Effect of early vs. delayed initiation of renal replacement therapy on mortality in critically ill patients with acute kidney injury: the ELAIN randomized clinical trial. JAMA, 2016, 315(20): 2190-2199.
12.	Kellum JA, Ronco C. The 17th Acute Disease Quality Initiative International Consensus Conference: introducing precision renal replacement therapy. Blood Purif, 2016, 42(3): 221-223.
13.	VA/NIH Acute Renal Failure Trial Network, Palevsky PM, Zhang JH, et al. Intensity of renal support in critically ill patients with acute kidney injury. N Engl J Med, 2008, 359(1): 7-20.
14.	RENAL Replacement Therapy Study Investigators, Bellomo R, Cass A, et al. Intensity of continuous renal-replacement therapy in critically ill patients. N Engl J Med, 2009, 361(17): 1627-1638.
15.	Kellum JA, Ronco C. Dialysis: results of RENAL--what is the optimal CRRT target dose?. Nat Rev Nephrol, 2010, 6(4): 191-192.
16.	孙世仁. CRRT治疗剂量再认识//中华医学会肾脏病学分会 2013 年学术年会, 福州: 中华医学会, 2013: S-74.
17.	冯哲, 陈香美, 聂飒飒. 重视急性肾损伤的临床研究. 中华肾病研究电子杂志, 2016, 5(6): 241-243.
18.	Joannidis M, Druml W, Forni LG, et al. Prevention of acute kidney injury and protection of renal function in the intensive care unit: update 2017: expert opinion of the working group on prevention, AKI section, European Society of Intensive Care Medicine. Intensive Care Med, 2017, 43(6): 730-749.

1. Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO clinical practice guideline for acute kidney injury. Kidney Int Suppl, 2012, 2(1): 1-138.
2. Mehta RL, Cerdá J, Burdmann EA, et al. International society of nephrology's 0 by 25 initiative for acute kidney injury (zero preventable deaths by 2025): a human rights case for nephrology. Lancet, 2015, 385(9987): 2616-2643.
3. Yang L, Xing G, Wang L, et al. Acute kidney injury in China: a cross-sectional survey. Lancet, 2015, 386(12): 1465-1471.
4. Nie S, Feng Z, Tang L, et al. Risk factor analysis for AKI including laboratory indicators: a nationwide multicenter study of hospitalized patients. Kidney Blood Press Res, 2017, 42(5): 761-773.
5. Beker BM, Corleto MG, Fieiras C, et al. Novel acute kidney injury biomarkers: their characteristics, utility and concerns. Int Urol Nephrol, 2018, 50(4): 705-713.
6. Alge JL, Arthur JM. Biomarkers of AKI: a review of mechanistic relevance and potential therapeutic implications. Clin J Am Soc Nephrol, 2015, 10(1): 147-155.
7. Murray PT, Mehta RL, Shaw A, et al. Potential use of biomarkers in acute kidney injury: report and summary of recommendations from the 10th Acute Dialysis Quality Initiative Consensus Conference. Kidney Int, 2014, 85(3): 513-521.
8. Wierstra BT, Kadri S, Alomar S, et al. The impact of "early" versus "late" initiation of renal replacement therapy in critical care patients with acute kidney injury: a systematic review and evidence synthesis. Crit Care, 2016, 20(1): 122.
9. Wald R, Adhikari NK, Smith OM, et al. Comparison of standard and accelerated initiation of renal replacement therapy in acute kidney injury. Kidney Int, 2015, 88(4): 897-904.
10. Gaudry S, Hajage D, Schortgen F, et al. Initiation strategies for renal-replacement therapy in the intensive care unit. N Engl J Med, 2016, 375(2): 122-133.
11. Zarbock A, Kellum JA, Schmidt C, et al. Effect of early vs. delayed initiation of renal replacement therapy on mortality in critically ill patients with acute kidney injury: the ELAIN randomized clinical trial. JAMA, 2016, 315(20): 2190-2199.
12. Kellum JA, Ronco C. The 17th Acute Disease Quality Initiative International Consensus Conference: introducing precision renal replacement therapy. Blood Purif, 2016, 42(3): 221-223.
13. VA/NIH Acute Renal Failure Trial Network, Palevsky PM, Zhang JH, et al. Intensity of renal support in critically ill patients with acute kidney injury. N Engl J Med, 2008, 359(1): 7-20.
14. RENAL Replacement Therapy Study Investigators, Bellomo R, Cass A, et al. Intensity of continuous renal-replacement therapy in critically ill patients. N Engl J Med, 2009, 361(17): 1627-1638.
15. Kellum JA, Ronco C. Dialysis: results of RENAL--what is the optimal CRRT target dose?. Nat Rev Nephrol, 2010, 6(4): 191-192.
16. 孙世仁. CRRT治疗剂量再认识//中华医学会肾脏病学分会 2013 年学术年会, 福州: 中华医学会, 2013: S-74.
17. 冯哲, 陈香美, 聂飒飒. 重视急性肾损伤的临床研究. 中华肾病研究电子杂志, 2016, 5(6): 241-243.
18. Joannidis M, Druml W, Forni LG, et al. Prevention of acute kidney injury and protection of renal function in the intensive care unit: update 2017: expert opinion of the working group on prevention, AKI section, European Society of Intensive Care Medicine. Intensive Care Med, 2017, 43(6): 730-749.

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