Preventing acute kidney injury in high-risk patients
- 1Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Munster, Muenster, Germany.
- 2Division of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University of Innsbruck, Innsbruck, Austria.
Abstract
Acute kidney injury (AKI) is a complex and heterogeneous clinical syndrome associated with substantial short- and long-term morbidity and mortality. AKI outcomes are strongly influenced by severity, duration, and recovery trajectory, with persistent AKI conferring a worse prognosis and higher risk of progression to chronic kidney disease. Early AKI detection is limited by the impediments of traditional functional criteria based on serum creatinine and urine output. Stress and damage biomarkers have demonstrated promise for early identification of subclinical AKI and for assessing risk of progression before a functional decline becomes apparent. Preventive strategies remain the foundation of AKI management. The Kidney Disease Improving Global Outcomes AKI care bundle, comprising haemodynamic optimization, close monitoring of kidney function parameters, and avoidance of nephrotoxins and hyperglycaemia, has demonstrated the strongest evidence-based approach for preventing AKI, especially when stress is early identified by biomarkers. Evidence for adjunctive interventions, including remote ischaemic preconditioning and selected pharmacological agents, remains inconsistent and context-dependent. Current evidence supports a paradigm shift towards earlier risk identification, biomarker-guided stratification, and early proactive implementation of targeted preventive strategies.
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BibTeX
@article{meerschdini2026preventing,
title = {{Preventing acute kidney injury in high-risk patients}},
author = {Melanie Meersch-Dini and Michael Joannidis},
journal = {Clinical kidney journal},
year = {2026},
month = jul,
doi = {10.1093/ckj/sfag228},
url = {https://europepmc.org/article/PMC/PMC13716672},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Preventing acute kidney injury in high-risk patients
AU - Melanie Meersch-Dini
AU - Michael Joannidis
PY - 2026
DA - 2026/07/15
JO - Clinical kidney journal
DO - 10.1093/ckj/sfag228
UR - https://europepmc.org/article/PMC/PMC13716672
AB - Acute kidney injury (AKI) is a complex and heterogeneous clinical syndrome associated with substantial short- and long-term morbidity and mortality. AKI outcomes are strongly influenced by severity, duration, and recovery trajectory, with persistent AKI conferring a worse prognosis and higher risk of progression to chronic kidney disease. Early AKI detection is limited by the impediments of traditional functional criteria based on serum creatinine and urine output. Stress and damage biomarkers have demonstrated promise for early identification of subclinical AKI and for assessing risk of progression before a functional decline becomes apparent. Preventive strategies remain the foundation of AKI management. The Kidney Disease Improving Global Outcomes AKI care bundle, comprising haemodynamic optimization, close monitoring of kidney function parameters, and avoidance of nephrotoxins and hyperglycaemia, has demonstrated the strongest evidence-based approach for preventing AKI, especially when stress is early identified by biomarkers. Evidence for adjunctive interventions, including remote ischaemic preconditioning and selected pharmacological agents, remains inconsistent and context-dependent. Current evidence supports a paradigm shift towards earlier risk identification, biomarker-guided stratification, and early proactive implementation of targeted preventive strategies.
SN - 2048-8505
SN - 2048-8513
ER -