Acute kidney injury (AKI) is a critical health issue globally. Heading into 2024, research in this field offers promising avenues for understanding and managing AKI. This article outlines three key research areas set to advance AKI knowledge and treatment.
Basic science: Exploring kidney cell dynamics
In 2024, scientists are focusing on the cellular and molecular dynamics of kidney cell death and recovery (1–4). Breakthroughs in this domain could revolutionize how we approach AKI treatment. Key focuses include kidney fibrosis and the processes of adaptive repair and maladaptive repair—the body's response to AKI. These insights have the potential for groundbreaking treatments that prevent cell death or enhance repair post-injury.
Artificial intelligence: Revolutionizing AKI prediction and management
Building on the work presented at ASN Kidney Week 2023, artificial intelligence (AI) and machine learning are redefining AKI research (5–7). We saw researchers developing predictive models through different stages of AKI, from detecting AKI to managing AKI. Specific examples include models that are designed to identify high-risk individuals early, complex algorithms for analyzing vast data sets, personalized diuretic strategies, dynamic risk assessment, and AI-guided dosing in AKI treatment. Such advancements could lead to earlier interventions, reducing AKI severity or preventing it.
Clinical research: A holistic, patient-centered approach
Current AKI research is adopting a holistic, patient-centered perspective, focusing on physical, emotional, and cognitive impacts (8). This approach recognizes AKI's broader effects on quality of life and explores interventions targeting the entire health spectrum of patients. A significant study in this domain is the IMPROVE AKI Cluster-Randomized Trial (9), which investigated the sustainability of team-based coaching in patient care. The AKINow Recovery Workgroup (https://epc.asn-online.org/projects/akinow/akinow-recovery-post-aki-workgroup/) is working on projects to improve post-AKI transition of care.
AKI research in 2024 will span basic science, AI, and clinical research (Figure 1). This synergy will result in more effective prevention and treatment strategies, improving outcomes for patients with AKI.
AKI research: What to watch for in 2024
Citation: Kidney News 16, 1
Footnotes
References
- 1.↑
American Society of Nephrology. ASN Kidney Week 2023 On-Demand. Developments in AKI and repair mechanisms. November 2, 2023. Available for purchase via https://education.asn-online.org/local/catalog/view/product.php?productid=118
- 2.
Cao S, et al. The epidermal growth factor receptor is an essential mediator of interstitial fibrosis development following AKI [Abstract]. J Am Soc Nephrol 2023; 34:1. https://www.asn-online.org/education/kidneyweek/2023/program-abstract.aspx?controlId=3939238
- 3.
Li C, Anders HJ. Differential roles of Regnase3 in resident macrophages vs. renal tubular epithelial cells in kidney injury [Abstract]. J Am Soc Nephrol 2023; 34:2. https://www.asn-online.org/education/kidneyweek/2023/program-abstract.aspx?controlId=3937469
- 4.↑
Chen Y, et al. Novel anti-inflammatory effects of IL-1 receptor in kidney myeloid cells following AKI [Abstract]. J Am Soc Nephrol 2023; 34:2. https://www.asn-online.org/education/kidneyweek/2023/program-abstract.aspx?controlId=3941800
- 5.↑
American Society of Nephrology. ASN Kidney Week 2023 On-Demand. Artificial intelligence and its promise to complement AKI care. November 2, 2023. Available for purchase via https://education.asn-online.org/local/catalog/view/product.php?productid=118
- 6.
Griffin BR, et al. Use of a recurrent neural network to predict development of nephrotoxic AKI in adults [Abstract]. J Am Soc Nephrol 2023; 34:30. https://www.asn-online.org/education/kidneyweek/2023/program-abstract.aspx?controlId=3945632
- 7.↑
Oh W, et al. Machine learning-guided novel subphenotypes of sepsis-associated persistent AKI [Abstract]. J Am Soc Nephrol 2023; 34:30. https://www.asn-online.org/education/kidneyweek/2023/program-abstract.aspx?controlId=3945752
- 8.↑
Bhatraju PK, et al. AKI is associated with long-term decline in cognitive function at 3 years: ASSESS-AKI study [Abstract]. J Am Soc Nephrol 2023; 34:29. https://www.asn-online.org/education/kidneyweek/2023/program-abstract.aspx?controlId=3940530
- 9.
Brown JR, et al. Team-based coaching intervention to improve contrast-associated acute kidney injury: A cluster-randomized trial. Clin J Am Soc Nephrol 2023; 18:315–326. doi: 10.2215/CJN.0000000000000067
