{"title":"PHENOTYPING REPAIR AFTER ACUTE KIDNEY INJURY: PRECISION MEDICINE TO CLINICAL TRIALS.","authors":"Chirag R Parikh, Jeanine Hernandez","doi":"","DOIUrl":null,"url":null,"abstract":"<p><p>Acute kidney injury (AKI) is common during hospitalization and is associated with long-term risk of readmissions and chronic kidney disease (CKD). Preclinical studies and novel urine biomarkers have demonstrated that subclinical inflammation and repair continue for several months after AKI. We conducted three clinical and translational studies to alleviate long-term sequelae after AKI. First, we assessed repair in deceased donor kidneys which can assist with organ allocation and reduce discard. In an ongoing study, organ procurement organizations are measuring repair biomarkers via lateral flow devices to assess organ quality and adding it to their workflow. Second, we performed research biopsies during AKI to interrogate kidney tissue with novel transcriptomic and proteomic techniques to advance therapeutic development. Third, we initiated pragmatic clinical trials to reduce readmissions after an episode of AKI by providing nurse navigator and pharmacist support to optimize blood pressure, fluid, and medication management.</p>","PeriodicalId":23186,"journal":{"name":"Transactions of the American Clinical and Climatological Association","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11316880/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Transactions of the American Clinical and Climatological Association","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Acute kidney injury (AKI) is common during hospitalization and is associated with long-term risk of readmissions and chronic kidney disease (CKD). Preclinical studies and novel urine biomarkers have demonstrated that subclinical inflammation and repair continue for several months after AKI. We conducted three clinical and translational studies to alleviate long-term sequelae after AKI. First, we assessed repair in deceased donor kidneys which can assist with organ allocation and reduce discard. In an ongoing study, organ procurement organizations are measuring repair biomarkers via lateral flow devices to assess organ quality and adding it to their workflow. Second, we performed research biopsies during AKI to interrogate kidney tissue with novel transcriptomic and proteomic techniques to advance therapeutic development. Third, we initiated pragmatic clinical trials to reduce readmissions after an episode of AKI by providing nurse navigator and pharmacist support to optimize blood pressure, fluid, and medication management.
急性肾损伤（AKI）是住院期间的常见病，与再住院和慢性肾病（CKD）的长期风险相关。临床前研究和新型尿液生物标志物证明，亚临床炎症和修复在急性肾损伤后会持续数月。我们开展了三项临床和转化研究，以减轻 AKI 后的长期后遗症。首先，我们评估了已故捐献者肾脏的修复情况，这有助于器官分配和减少废弃。在一项正在进行的研究中，器官采购组织正在通过侧流装置测量修复生物标志物，以评估器官质量，并将其纳入工作流程。其次，我们在 AKI 期间进行了研究性活检，利用新型转录组学和蛋白质组学技术对肾脏组织进行检测，以推动治疗方法的开发。第三，我们启动了务实的临床试验，通过提供护士导航和药剂师支持来优化血压、输液和药物管理，从而减少急性肾损伤发作后的再入院率。
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