Molecular Mechanisms of AKI in the Elderly: From Animal Models to Therapeutic Intervention

Journal of Clinical Medicine

Elena Ranieri¹  GiuseppeStefano Netti¹  Martina Calvaruso²  Rossana Franzin³  Loreto Gesualdo³  Barbara Infante⁴  Desirèe Madio⁴  Giuseppe Castellano⁴  Fabio Sangregorio⁴  Giovanni Stallone⁴  Annamaria Maiorano⁴ 

[1] Clinical Pathology, Department of Surgical and Medical Sciences, University of Foggia, Viale Pinto Luigi 251, 71122 Foggia, Italy;Nephrology, Dialysis and Transplantation Unit, Department of Biomedical Sciences, University of Foggia, 71122 Foggia, Italy;Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari, 70124 Bari, Italy;Nephrology, Dialysis and Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto Luigi 251, 71122 Foggia, Italy;

关键词: acute kidney injury;    elderly;    risk factors;    mortality;    intensive care;    renal replacement therapy;   

DOI  :  10.3390/jcm9082574

来源: DOAJ

【 摘 要 】

Acute kidney injury (AKI), a critical syndrome characterized by a sudden reduction of renal function, is a common disorder among elderly patients particularly in Intensive Care Unit (ICU). AKI is closely associated with both short- and long-term mortality and length of hospital stay and is considered a predictor of chronic kidney disease (CKD). Specific hemodynamic, metabolic, and molecular changes lead to increased susceptibility to injury in the aged kidney; therefore, certain causes of AKI such as the prerenal reduction in renal perfusion or vascular obstructive conditions are more common in the elderly; moreover, AKI is often multifactorial and iatrogenic. Older patients present several comorbidities (diabetes, hypertension, heart failure) and are exposed to multiple medical interventions such as the use of nephrotoxic contrasts media and medications, which can also trigger AKI. Considering the emerging relevance of this condition, prevention and treatment of AKI in the elderly should be crucial in the internist and emergency setting. This review article summarizes the incidence, the risk factors, the pathophysiology, the molecular mechanisms and the strategies of prevention and treatment of AKI in elderly patients.

【 授权许可】

Unknown