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Review
. 2023 May 1:16:1905-1921.
doi: 10.2147/JIR.S404983. eCollection 2023.

Long-Term Effects of Severe Burns on the Kidneys: Research Advances and Potential Therapeutic Approaches

Guang Yang #  1   2 , Lishan Tan #  1 , Hua Yao  3 , Zuying Xiong  1 , Jun Wu  4   5 , Xiaoyan Huang  1
Affiliations
Review

Long-Term Effects of Severe Burns on the Kidneys: Research Advances and Potential Therapeutic Approaches

Guang Yang et al. J Inflamm Res. .

Abstract

Burns are a seriously underestimated form of trauma that not only damage the skin system but also cause various complications, such as acute kidney injury (AKI). Recent clinical studies have shown that the proportion of chronic kidney diseases (CKD) in burn patients after discharge is significantly higher than that in the general population, but the mechanism behind this is controversial. The traditional view is that CKD is associated with hypoperfusion, AKI, sepsis, and drugs administered in the early stages of burns. However, recent studies have shown that burns can cause long-term immune dysfunction, which is a high-risk factor for CKD. This suggests that burns affect the kidneys more than previously recognized. In other words, severe burns are not only an acute injury but also a chronic disease. Neglecting to study long-term kidney function in burn patients also results in a lack of preventive and therapeutic methods being developed. Furthermore, stem cells and their exosomes have shown excellent comprehensive therapeutic properties in the prevention and treatment of CKD, making them increasingly the focus of research attention. Their engineering strategy further improved the therapeutic performance. This review will focus on the research advances in burns on the development of CKD, illustrating the possible mechanism of burn-induced CKD and introducing potential biological treatment options and their engineering strategies.

Keywords: acute kidney injury; chronic kidney diseases; cytokine storm; exosomes; inflammation; sepsis; stem cells.

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Conflict of interest statement

The authors declare no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Classification of kidney injury. AKI was defined as a more than 50% rise in serum creatinine within 7 days, an increase of ≥ 0.3 mg/dL within 2 days, or oliguria for more than 4 hours. AKD is manifested by AKI or glomerular filtration rate (GFR) < 60 mL/min/1.73 m2, or a GFR decline of more than 35% from baseline value, or elevated serum creatinine levels (50% higher than baseline), or the presence of significant pathological injury and structural abnormalities, and the entire abnormal process lasts for less than 3 months. CKD refers to kidney structure and dysfunction caused by various reasons, or unexplained GFR decline (<60mL/min·1.73 m2); and the disease must be more than 3 months. Note: AKI, acute kidney injury; AKD, acute kidney disease; CKD, chronic kidney disease; GFR, glomerular filtration rate.
Figure 2
Figure 2
The causes of burn-induced AKI can be divided into two stages.
Figure 3
Figure 3
Different stages of post-burn kidney injury.
Figure 4
Figure 4
Schematic diagram of the etiology of post-burn CKD.
Figure 5
Figure 5
Therapeutic mechanisms of stem cells and exosomes and their engineering strategies.
See this image and copyright information in PMC

References

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