Zoccali Carmine, Lameire Norbert, Ronco Claudio, Carlson Nicholas, Faguer Stanislas, Selby Nicholas, Ostermann Marlies, Mallamaci Francesca, Vanholder Raymond
Renal Research Institute, New York, USA.
Institute of Molecular Biology and Genetics (Biogem), Ariano Irpino, Italy.
Nephrol Dial Transplant. 2025 May 12. doi: 10.1093/ndt/gfaf090.
Acute Kidney Injury (AKI) and Chronic Kidney Disease (CKD) are interconnected, with AKI often leading to CKD and vice versa. Despite research advances, their causal relationship in clinical settings remains unclear. Inflammation, oxidative stress, and maladaptive repair are key factors in AKI's progression to CKD. AKI episodes may hasten CKD progression, influenced by demographics, comorbidities, and treatment factors like blood pressure control. This underscores the need for careful management to prevent long-term damage. Prospective cohort studies addressing confounding factors are essential to understanding AKI's impact on CKD. These studies should use precise definitions and measurements to clarify causal pathways and risk factors. Investigating asymptomatic AKI in the general population and CKD patients could offer insights into progression mechanisms and prevention strategies. Understanding AKI-CKD interplay is crucial for developing interventions and improving outcomes, making it a scientific and public health priority.
急性肾损伤（AKI）和慢性肾脏病（CKD）相互关联，AKI常导致CKD，反之亦然。尽管研究取得了进展，但它们在临床环境中的因果关系仍不明确。炎症、氧化应激和适应性修复不良是AKI进展为CKD的关键因素。AKI发作可能会加速CKD的进展，这受到人口统计学、合并症以及血压控制等治疗因素的影响。这突出了谨慎管理以防止长期损害的必要性。针对混杂因素的前瞻性队列研究对于理解AKI对CKD的影响至关重要。这些研究应使用精确的定义和测量方法来阐明因果途径和风险因素。在普通人群和CKD患者中调查无症状AKI可能有助于深入了解进展机制和预防策略。了解AKI与CKD的相互作用对于制定干预措施和改善治疗结果至关重要，使其成为科学和公共卫生的优先事项。
