State of the art: Renal recovery after AKI - from basic science to clinical practice.

Purpose: Acute kidney injury (AKI) is common in critically ill patients and associated with a high risk of mortality, chronic kidney disease (CKD) and cardiovascular morbidity. The risks are higher in patients with incomplete or no renal recovery. The purpose of this review is to summarize the current understanding of the mechanisms of renal recovery, list some key risk factors for nonrecovery and highlight knowledge gaps.

Pregnancy-associated acute kidney injury - consensus report of the 32nd Acute Disease Quality Initiative workgroup.

Acute kidney injury (AKI) during pregnancy and the postpartum period, known as pregnancy-associated AKI (PrAKI), is an important health concern and driver of health inequity worldwide. Causes of PrAKI include sepsis, autoimmune disorders and pregnancy-specific pathologies such as hypertensive disorders. Common risk factors include maternal comorbidities and use of nephrotoxic medications.

Epidemiology and long-term outcomes of critically ill patients with severe AKI in India and Southeast Asia.

Background: Acute kidney injury (AKI) is associated with significant short-term morbidity and mortality. However, its long-term outcomes, particularly in resource-limited settings, remain poorly understood. This study aimed to evaluate 2-year major adverse kidney events (MAKE) in patients with severe AKI.

Sex and gender considerations in randomized controlled trials in critical care nephrology: a meta-epidemiologic study.

Background: How sex and gender are considered in randomized controlled trials (RCTs) in critical care nephrology is unclear. We aimed to perform a meta-epidemiologic study to describe the representation, sex and gender reporting, and sex- and gender-based analyses (SGBA) in high-impact RCTs in critical care nephrology.

Methods: We searched the Web of Science Core Collection for critical care nephrology papers from 2000 to 2024.

Hypertonic Citrate Solution Protocol Associated with Longer Filter Lifetime in Critically Ill Patients Requiring Continuous Kidney Replacement Therapy.

Introduction: Regional citrate anticoagulation (RCA) serves as the first line of anticoagulants in continuous kidney replacement therapy (CKRT). Premature circuit clotting is associated with increased workload, costs, and adverse patient outcomes. Current evidence shows limited studies on the relationship between RCA protocols and circuit clotting in RCA CKRT.

The effects of urine alkalinization on kidney function in critically ill patients with COVID-19: a proof-of-concept randomized clinical trial.

Background: Acute kidney injury (AKI) is a common complication of COVID-19. While the exact mechanisms remain unclear, direct viral infection of renal tubular epithelial cells is hypothesized. Given the pH-dependent entry of coronaviruses into host cells, urine alkalinization was proposed as a potential preventive strategy.

The role of sex and gender in acute kidney injury-consensus statements from the 33rd Acute Disease Quality Initiative.

Sex differences exist in acute kidney injury (AKI), and the role that sex and gender play along the AKI care continuum remains unclear. The 33rd Acute Disease Quality Initiative meeting evaluated available data on the role of sex and gender in AKI and identified knowledge gaps. Data from experimental models, pathophysiology, epidemiology, clinical care, gender, social determinants of health, education, and advocacy were reviewed.

Acute kidney injury.

Acute kidney injury (AKI) is a common, heterogeneous, multifactorial condition, which is part of the overarching syndrome of acute kidney diseases and disorders. This condition's incidence highest in low-income and middle-income countries. In the short term, AKI is associated with increased mortality, an increased risk of complications, extended stays in hospital, and high health-care costs.

Deceptive air: Unravelling pseudo-peritonitis in peritoneal dialysis patients-A diagnostic challenge.

Pneumoperitoneum, or free air in the peritoneal cavity, typically indicates visceral organ perforation requiring urgent surgical intervention. In peritoneal dialysis (PD) patients, however, it can occur without prior surgery or trauma, often due to technical errors, and may mimic peritonitis, risking misdiagnosis and unnecessary treatment. We report a case of a 73-year-old male PD patient presenting with fever, abdominal pain, and bowel ileus, initially raising concerns for organ perforation due to pneumoperitoneum.

Severe bupropion intoxication successfully treated with resin adsorber haemoperfusion.

Bupropion is used as smoking cessation drug and antidepressant. Drug overdose has multi-system involvement including neurotoxicity and cardiovascular collapse. Use of haemoperfusion in bupropion toxicity is generally not useful, however in life-threatening condition it could be a life saver.

Outcomes of extracorporeal blood purification with oXiris® membrane in critically ill patients: A systematic review and meta-analysis.

Purpose: To evaluate the efficacy of the novel oXiris® membrane in critically ill adult patients.

Methods: We systematically searched MEDLINE, EMBASE, and CENTRAL from inception to 01/06/2023 for relevant randomised controlled trials (RCTs) and non-randomised studies of intervention (NRSI). The primary outcome was overall mortality.

Lower-Dosage Acute Peritoneal Dialysis versus Acute Intermittent Hemodialysis in Acute Kidney Injury: A Randomized Controlled Trial.

Key Points: The efficacy of acute peritoneal dialysis is still controversial. There was no significant difference in 28-day mortality between acute peritoneal dialysis and intermittent hemodialysis.

Background: Lower delivered dose of acute peritoneal dialysis (PD) in AKI requires less resources but raises concerns regarding adequate solute and water clearance.

From ICU Syndromes to ICU Subphenotypes: Consensus Report and Recommendations for Developing Precision Medicine in the ICU.

Critical care uses syndromic definitions to describe patient groups for clinical practice and research. There is growing recognition that a "precision medicine" approach is required and that integrated biologic and physiologic data identify reproducible subpopulations that may respond differently to treatment. This article reviews the current state of the field and considers how to successfully transition to a precision medicine approach.

The Role of Erythropoietin Levels in Predicting Long-Term Outcomes following Severe Acute Kidney Injury.

Introduction: Acute kidney injury (AKI) survivors are at an increased risk of chronic kidney disease, end-stage kidney disease, and mortality. Little is known about the effect of erythropoietin (EPO), a kidney-producing hormone, in post-AKI setting. We aimed to investigate the role of EPO as a predictor of long-term outcomes in post-severe AKI survivors.

Micronutrient Losses during Continuous Renal Replacement Therapy.

Acute kidney injury impacts the micronutrient status by various mechanisms including decreased enteral absorption, changes in redistribution, altered metabolism, and increased consumption. When renal replacement therapy (RRT) is applied, there are additional losses of vitamins, trace elements, and amino acids, and their derivatives due to diffusion or adhesion. Varied data exist regarding the degree of micronutrient losses and plasma concentrations in patients who receive RRT, and these differ by RRT modality, dose, duration, and type of micronutrient.

Acute kidney injury in patients receiving immune checkpoint inhibitors: a retrospective real-world study.

Background: Immune checkpoint inhibitors (ICPi) can cause immune-related adverse events (irAEs) including acute kidney injury (AKI). We investigated the incidence of ICPi-associated AKI (ICPi-AKI) and AKI from other causes (non-ICPi-AKI) in cancer patients treated with ICPi.

Methods: This was a single-centre retrospective cohort study of patients receiving ICPi therapy between December 2011 and August 2020.

Long-term effects of restriction of intravenous fluid in adult ICU patients with septic shock.

Purpose: To assess long-term outcomes of restrictive versus standard intravenous (IV) fluid therapy in adult intensive care unit (ICU) patients with septic shock included in the European Conservative versus Liberal Approach to Fluid Therapy in Septic Shock in Intensive Care (CLASSIC) trial.

Methods: We conducted the pre-planned analyses of mortality, health-related quality of life (HRQoL) using EuroQol (EQ)-5D-5L index values and EQ visual analogue scale (VAS), and cognitive function using Mini Montreal Cognitive Assessment (Mini MoCA) test at 1 year. Deceased patients were assigned numerical zero for HRQoL as a state equal to death and zero for cognitive function outcomes as worst possible score, and we used multiple imputation for missing data on HRQoL and cognitive function.

Micronutrient use in critical care: Survey of clinical practice.

Background & Aims: Micronutrients, principally vitamins and minerals, play an important role both in health and in disease. Parenteral micronutrient products are commonly prescribed for critically ill patients both in line with the terms of the product's license, and for other indications where there is an underpinning physiological rationale, or precedent, for their use but little evidence. This survey sought to understand United Kingdom (UK) prescribing practice in this area.

The Role of Cell Cycle Arrest Biomarkers for Predicting Acute Kidney Injury in Critically Ill COVID-19 Patients: A Multicenter, Observational Study.

Objectives: Patients with COVID-19-associated acute respiratory distress syndrome (ARDS) have a high risk for developing acute kidney injury (AKI) which is associated with an increased risk of death and persistent renal failure. Early prediction of AKI is crucial in order to implement preventive strategies. The purpose of this study was to investigate the predictive performance of tissue inhibitor of metalloproteinases 2 and insulin like growth factor binding protein 7 (TIMP-2) × (IGFBP7) in critically ill patients with COVID-19-associated ARDS.

Biomarker-guided intervention to prevent acute kidney injury after major surgery (BigpAK-2 trial): study protocol for an international, prospective, randomised controlled multicentre trial.

Introduction: Previous studies demonstrated that the implementation of the Kidney Disease Improving Global Outcomes (KDIGO) guideline-based bundle, consisting of different supportive measures in patients at high risk for acute kidney injury (AKI), might reduce rate and severity of AKI after surgery. However, the effects of the care bundle in broader population of patients undergoing surgery require confirmation.

Methods And Analysis: The BigpAK-2 trial is an international, randomised, controlled, multicentre trial.

Changing epidemiology of acute kidney injury in critically ill patients with COVID-19: a prospective cohort.

Background: Acute kidney injury (AKI) is common in critically ill patients with coronavirus disease-19 (COVID-19). We aimed to explore the changes in AKI epidemiology between the first and the second COVID wave in the United Kingdom (UK).

Methods: This was an observational study of critically ill adult patients with COVID-19 in an expanded tertiary care intensive care unit (ICU) in London, UK.

Circulating and urinary microRNAs profile for predicting renal recovery from severe acute kidney injury.

Background: There is little known about the contribution of microRNAs (miRNAs) in the recovery from acute kidney injury (AKI). This study aimed to discover and validate miRNA profiles for predicting renal recovery from severe AKI.

Patients And Methods: A prospective observational study was conducted between June 2020 and January 2021.