Unveiling the enigma of acute kidney disease: predicting prognosis, exploring interventions, and embracing a multidisciplinary approach.
Szu-Yu PanThomas Tao-Min HuangZheng-Hong JiangLi-Chun LinI-Jung TsaiTsung-Lin WuChih-Yi HsuTing WangHui-Chuen ChenYu-Feng LinVin-Cent WuPublished in: Kidney research and clinical practice (2024)
Acute kidney disease (AKD) is a critical transitional period between acute kidney injury and chronic kidney disease. The incidence of AKD following acute kidney injury is approximately 33.6%, and it can occur without identifiable preceding acute kidney injury. The development of AKD is associated with increased risks of chronic kidney disease, dialysis, and mortality. Biomarkers and subphenotypes are promising tools to predict prognosis in AKD. The complex clinical situations in patients with AKD necessitate a comprehensive and structured approach, termed "KAMPS" (kidney function check, advocacy, medications, pressure, sick day protocols). We introduce "MAND-MASS," an acronym devised to summarize the reconciliation of medications during episodes of acute illness, as a critical component of the sick day protocols at AKD. A multidisciplinary team care, consisting of nephrologists, pharmacists, dietitians, health educators, and nurses, is an optimal model to achieve the care bundle in KAMPS. Although the evidence for patients with AKD is still lacking, several potential pharmacological agents may improve outcomes, including but not limited to angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, mineralocorticoid receptor antagonists, sodium-glucose cotransporter 2 inhibitors, and glucagon-like peptide 1 receptor agonists. In conclusion, accurate prognosis prediction and effective treatment for AKD are critical yet unmet clinical needs. Future studies are urgently needed to improve patient care in this complex and rapidly evolving field.
Keyphrases
- acute kidney injury
- angiotensin converting enzyme
- chronic kidney disease
- liver failure
- healthcare
- end stage renal disease
- quality improvement
- cardiac surgery
- angiotensin ii
- respiratory failure
- palliative care
- drug induced
- aortic dissection
- mental health
- risk factors
- human health
- public health
- peritoneal dialysis
- hepatitis b virus
- high resolution
- pain management
- type diabetes
- metabolic syndrome
- intensive care unit
- health information
- social media
- skeletal muscle
- insulin resistance
- acute respiratory distress syndrome
- replacement therapy
- climate change
- chronic pain