Recent advances in the understanding of acute kidney injury

Abstract

Acute kidney injury (AKI) is a common clinical entity associated with high morbidity and mortality and clinical costs. The pathophysiology is multifaceted and involves inflammation, tubular injury, and vascular damage. Recently identified components include necroptosis, a special form of cell death, and autophagy. Most of the pathophysiological knowledge is obtained from animal models but these do not directly reflect the reality of the clinical situation. Tubular cells have a remarkable capacity to regenerate, and the role of stem/progenitor cells is discussed. Acute kidney injury is frequently associated with chronic kidney disease, and the implications are widespread.

Figure 1.. Pathophysiological components of acute kidney injury

Acute kidney injury is most commonly caused by ischemic or toxic injury and occurs in the setting of sepsis. Components of the pathophysiology include inflammatory responses as well as tubular and vascular damage and its consequences. Abbreviations: NK, natural killer.