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Promoting renal recovery in critical illness 

Promoting renal recovery in critical illness
Chapter:
Promoting renal recovery in critical illness
Author(s):

Nattachai Srisawat

and John A. Kellum

DOI:
10.1093/med/9780199600830.003.0379
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date: 30 November 2020

Better understanding the process of renal recovery following acute kidney injury (AKI) is one of the key steps in improving AKI outcome. We are still lacking the standard definition of renal recovery. Recent progress on the pathophysiology of renal injury and recovery is encouraging. Repopulation of surviving renal tubular epithelial cells with the assistance of certain renal epithelial cell and specific growth factors, play a major role in the recovery process. Moreover, accurate prediction would help physicians distinguish patients with poor renal prognosis in whom further therapy is likely to be futile from those who are likely to have good renal prognosis. Unfortunately, current general clinical severity scores (APACHE, SOFA, etc.) and AKI-specific severity scores are not good predictors of renal recovery. This review describes the current definition, pathobiology of renal recovery, epidemiology of renal recovery, the role of clinical severity scores, and novel biomarkers in predicting renal recovery, and strategies for facilitating renal recovery.

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