| Acute Kidney Injury and Chronic Kidney Disease as Interconnected Syndromes |
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So-Young Lee |
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Division of Nephrology, Department of Internal Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea |
| 급성 신손상: 만성 콩팥병의 원인인가? |
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이소영 |
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을지대학교 의과대학 을지병원 신장내과 |
Correspondence:
So-Young Lee, Tel: +82-2-970-8457, Fax: +82-2-927-5344, Email: leesy1146@eulji.ac.kr
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| This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
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| Abstract |
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Although it was thought that survivors from an acute kidney injury (AKI) recovered kidney function completely, cumulative observational data have shown that AKI can cause end-stage renal disease directly, increase the risk of developing incident chronic kidney disease (CKD), and worsen an underlying CKD. These data have confirmed an association between AKI and an increased risk of permanent kidney damage, with subsequent development of CKD. However, many studies have focused on early injury following ischemic insult; the mechanisms of long-term injury remain poorly understood. Established and new data suggest that endothelial injury, loss of peritubular capillary volume, and chronic hypoxia affect structural changes after an ischemic insult. The repair process after acute kidney injury can be both adaptive and maladaptive. A maladaptive response includes persistent upregulation of proinflammatory and profibrotic signals and maladaptive cellular regeneration; this is thought to be one of the mechanisms leading to progressive renal injury and, ultimately, end-stage renal disease. The purpose of this brief review was to focus on recent advances related to the mechanisms of the progression from AKI to CKD. This review suggests that a new approach is required to manage AKI patients to prevent and/or arrest CKD progression. |
| Key Words:
AKI; CKD; Endothelial injury; Chronic hypoxia; Inflammation |
| 주제어:
급성 신손상; 만성 콩팥병; 내피세포 손상; 만성 허혈; 염증 |
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