Neyra Javier A, Moe Orson W
Department of Medicine, University of Alabama, Birmingham, Alabama, USA.
Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Nephron. 2023;147(12):747-753. doi: 10.1159/000534228. Epub 2023 Sep 27.
Acute kidney injury (AKI) is a highly prevalent condition with multiple acute and chronic consequences. Survivors of AKI are at risk of AKI-to-chronic kidney disease (CKD) transition, which carries significant morbidity and mortality. One retrospective analysis showed increased risk of bone fracture post-AKI in humans, which was independent of CKD development. While there are several theoretical reasons for late disturbances of bone health post-AKI, no definitive data are available to date. An important question is whether there are bone sequelae from AKI that are independent of CKD, meaning bone disease prior to the onset, or in the absence of CKD - a form of "post-AKI osteopathy." While preclinical studies examining bone health after acute stressors have focused mostly on sepsis models, multiple experimental AKI models are readily available for longitudinal bone health interrogation. Future research should be tailored to define whether AKI is a risk factor, independent of CKD, for bone disease and if present, the time course and type of bone disease. This review summarizes a fraction of the existing data to provide some guidance in future research efforts.
急性肾损伤（AKI）是一种非常普遍的病症，会导致多种急慢性后果。AKI幸存者有发生AKI向慢性肾脏病（CKD）转变的风险，这种转变会带来显著的发病率和死亡率。一项回顾性分析显示，人类在发生AKI后骨折风险增加，且该风险与CKD的发展无关。虽然对于AKI后骨骼健康出现延迟紊乱存在多种理论原因，但迄今为止尚无确切数据。一个重要问题是，AKI是否存在独立于CKD的骨骼后遗症，即在发病前或不存在CKD的情况下出现骨病——一种“AKI后骨病”的形式。虽然此前针对急性应激源后骨骼健康的临床前研究主要集中在脓毒症模型上，但有多种实验性AKI模型可用于对骨骼健康进行纵向研究。未来的研究应旨在确定AKI是否是一种独立于CKD的骨病风险因素，如果是，确定骨病的病程和类型。本综述总结了部分现有数据，为未来的研究工作提供一些指导。
