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Acute Kidney Injury (AKI): Novel Strategies of Diagnosis and Treatments
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Acute Kidney Injury (AKI): Novel Strategies of Diagnosis and Treatments

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Nephrology & Urology".

Deadline for manuscript submissions: 25 August 2024 | Viewed by 1248

Special Issue Editor

Dr. Anna Clementi

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Guest Editor
Nephrology and Dialysis Unit, Santa Marta and Santa Venera Hospital, 95024 Acireale, Catania, Italy
Interests: acute kidney injury; chronic kidney disease; cardio-renal syndromes
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Acute kidney injury (AKI) is a major complication in hospitalized and intensive care unit patients and is independently associated with short- and long-term mortality. Furthermore, AKI is associated with high morbidity and mortality and a greater risk of adverse outcomes after hospital discharge. After AKI, the incidences of chronic kidney disease and end-stage renal disease are increased. AKI is not a single disease but a series of heterogeneous syndromes, and if these lesions are left untreated, the patient's condition can worsen, resulting in complete loss of kidney function or death.

As there are many causes of acute kidney injury, more in-depth studies are still needed. For this Special Issue, we are calling on researchers and clinicians to submit valuable research on AKI to generate more knowledge and awareness of this issue, as has been done in nephrology, internal medicine, critical care, and other disciplines and skill areas.

Dr. Anna Clementi
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • acute kidney injury
  • acute renal failure
  • chronic kidney diseases
  • nephritis
  • critical care
  • renal replacement therapy
  • inflammation
  • risk factors
  • therapy
  • diagnosis
  • outcomes
  • predictors

Published Papers (2 papers)

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Research

8 pages, 320 KiB  
Article
Evaluating Short-Term Outcomes of Tunneled and Non-Tunneled Central Venous Catheters in Hemodialysis
by Niccolò Morisi, Martina Montani, Edwidge Ntouba Ehode, Grazia Maria Virzì, Salvatore Perrone, Vittoria Malaguti, Marco Ferrarini and Gabriele Donati
J. Clin. Med. 2024, 13(13), 3664; https://doi.org/10.3390/jcm13133664 - 23 Jun 2024
Viewed by 318
Abstract
Background: The necessity of using central venous catheters (CVCs) in hemodialysis, coupled with their associated complications, remains a critical concern in nephrology. This study aims to compare the short-term prognosis of tunneled (T-CVC) and non-tunneled (NT-CVC) CVCs in acute hemodialysis patients, specifically [...] Read more.
Background: The necessity of using central venous catheters (CVCs) in hemodialysis, coupled with their associated complications, remains a critical concern in nephrology. This study aims to compare the short-term prognosis of tunneled (T-CVC) and non-tunneled (NT-CVC) CVCs in acute hemodialysis patients, specifically focusing on infection rates, malpositioning, and lumen thrombosis within the first three weeks post-insertion. Methods: A retrospective analysis was conducted on 176 CVCs placed between January and December 2023 at the Policlinico di Modena and the Ospedale Civile di Baggiovara. Patient demographics, CHA2DS2-VASc scores, and comorbid conditions were recorded at the time of catheter placement. Outcomes assessed included catheter-related infections, malpositioning, and lumen thrombosis. Statistical analyses, including Chi-square tests, Fisher’s exact tests, and Kaplan–Meier survival analysis, were performed to evaluate differences between T-CVCs and NT-CVCs. Results: The sample comprised 43% females with a mean age of 69.3 years (SD 13.9) and a mean CHADS-VASC score of 3.72 (SD 1.4). Hypertension (90%) was the most prevalent comorbidity. Of the 176 CVCs, 127 were T-CVCs and 49 were NT-CVCs. Infection rates were 3.15% for T-CVCs and 8.16% for NT-CVCs (p = 0.07). Malpositioning occurred in 0.79% of T-CVCs and 4.08% of NT-CVCs (p = 0.47). There was one case of lumen thrombosis in the NT-CVC group. Kaplan–Meier analysis indicated a significant divergence in infection-related catheter survival favoring T-CVCs after ten days (p = 0.034). Conclusions: While non-tunneled CVCs do not significantly alter short-term prognosis compared to tunneled CVCs, the latter show a better infection-related survival rate beyond ten days. Therefore, primary insertion of T-CVCs may be preferable when resources and clinical conditions permit, although NT-CVCs remain a viable option when immediate T-CVC insertion is challenging. Full article
(This article belongs to the Special Issue Acute Kidney Injury (AKI): Novel Strategies of Diagnosis and Treatments)
13 pages, 994 KiB  
Article
Obesity and Acute Kidney Injury in Patients with ST-Elevation Myocardial Infarction
by Vojko Kanic, David Suran and Gregor Kompara
J. Clin. Med. 2023, 12(23), 7311; https://doi.org/10.3390/jcm12237311 - 25 Nov 2023
Viewed by 677
Abstract
Background: Data on the association between obesity and acute kidney injury (AKI) in patients with ST-elevation myocardial infarction (STEMI) are sparse and inconclusive. We aimed to evaluate the association between obesity and AKI and the outcome in these patients. Methods: A retrospective observational [...] Read more.
Background: Data on the association between obesity and acute kidney injury (AKI) in patients with ST-elevation myocardial infarction (STEMI) are sparse and inconclusive. We aimed to evaluate the association between obesity and AKI and the outcome in these patients. Methods: A retrospective observational study of 3979 STEMI patients undergoing percutaneous coronary intervention (PCI) was performed at a single center. Patients with and without AKI were compared. Patients were also divided into three categories according to BMI, and these were compared. All-cause mortality was determined at 30 days and over a median period of 7.0 years. Results: The incidence of AKI was similar in all BMI categories. There was no association between BMI categories and AKI (p = 0.089). The Spearman correlation coefficient between BMI categories and AKI showed no correlation (r = −0.005; p = 0.75). More AKI patients died within 30 days and in the long term [137 (18.5%) and 283 (38.1%) patients in the AKI group died compared to 118 (3.6%) and 767 (23.1%) in the non-AKI group; p < 0.0001]. AKI was harmful in all BMI categories (p < 0.0001) and was associated with more than a 2.5-fold and a 1.5-fold multivariable-adjusted 30-day and long-term mortality risk, respectively (aOR 2.59; 95% CI 1.84–3.64; p < 0.0001, aHR 1.54; 95% CI 1.32–1.80; p < 0.0001). BMI categories were not associated with 30-day mortality (p = 0.26) but were associated with long-term mortality (p < 0.0001). Overweight and obese patients had an approximately 25% lower long-term multivariable-adjusted risk of death than normal-weight patients. In patients with AKI, BMI was only associated with long-term risk (p = 0.022). Obesity had an additional beneficial effect in these patients, and only patients with obesity, but not overweight patients, had a lower multivariable adjusted long-term mortality risk than normal-weight patients (aHR 062; 95% CI 0.446–0.88 p = 0.007). Conclusions: In patients who experienced AKI, obesity had an additional positive modifying effect. Our data suggest that the incidence of AKI in STEMI patients is not BMI-dependent. Full article
(This article belongs to the Special Issue Acute Kidney Injury (AKI): Novel Strategies of Diagnosis and Treatments)
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