Introduction Nephron Clin Pract 2014;127:117–118 DOI: 10.1159/000363253
Published online: September 24, 2014
Changing Paradigms in Acute Kidney Injury: From Mechanisms to Management – Proceedings of the 5th Annual UAB-UCSD O’Brien Center Symposium (San Diego, Calif., USA, March 4, 2014) Ravindra L. Mehta a Paul W. Sanders b, c Anupam Agarwal b, c
a
Division of Nephrology-Hypertension, Department of Medicine, University of California San Diego, San Diego, Calif., and b Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, and c Birmingham Veterans Administration Medical Center, Birmingham, Ala., USA
Contributions of These Proceedings 1 Kasimsetty SG, DeWolf SE, Shigeoka AA, McKay DB: Regulation of TLR2 and NLRP3 in primary murine renal tubular epithelial cells. Nephron Clin Pract 2014;127:119–123. 2 Ince C: The central role of renal microcirculatory dysfunction in the pathogenesis of acute kidney injury. Nephron Clin Pract 2014;127:124–128. 3 Johnson ACM, Zager RA: Renal cortical pyruvate as a potentially critical mediator of acute kidney injury. Nephron Clin Pract 2014;127:129–132. 4 Vallon V: Do tubular changes in the diabetic kidney affect the susceptibility to acute kidney injury? Nephron Clin Pract 2014;127: 133–138. 5 Noel S, Martina-Lingua MN, Bandapalle S, Pluznick J, Hamad ARA, Peterson DA, Rabb H: Intestinal microbiota-kidney cross talk in acute kidney injury and chronic kidney disease. Nephron Clin Pract 2014;127:139–143. 6 Peters E, Masereeuw R, Pickkers P: The potential of alkaline phosphatase as a treatment for sepsis-associated acute kidney injury. Nephron Clin Pract 2014;127:144–148.
7 Nourbakhsh N, Singh P: Role of renal oxygenation and mitochondrial function in the pathophysiology of acute kidney injury. Nephron Clin Pract 2014;127:149–152. 8 Gigliotti JC, Okusa MD: The spleen: the forgotten organ in acute kidney injury of critical illness. Nephron Clin Pract 2014;127:153– 157. 9 Shin HJ, McCullough PA: Focus on lipids: high-density lipoprotein cholesterol and its associated lipoproteins in cardiac and renal disease. Nephron Clin Pract 2014;127:158–164. 10 Ball T, McCullough PA: Statins for the prevention of contrast-induced acute kidney injury. Nephron Clin Pract 2014;127:165–171. 11 Garzotto F, Zanella M, Ronco C: The evolution of pediatric continuous renal replacement therapy. Nephron Clin Pract 2014; 127:172–175. 12 Devarajan P, Murray P: Biomarkers in acute kidney injury: are we ready for prime time? Nephron Clin Pract 2014;127:176–179. 13 Endre ZH: Using biomarkers for acute kidney injury: barriers and solutions. Nephron Clin Pract 2014;127:180–184. 14 Srisawat N, Murugan R, Kellum JA: Repair or progression after AKI: a role for biomarkers? Nephron Clin Pract 2014;127:185–189.
The Symposium was supported by NIH UAB-UCSD O‘Brien Center grant P30 DK079337.
© 2014 S. Karger AG, Basel 1660–2110/14/1274–0117$39.50/0 E-Mail [email protected] www.karger.com/nec
Ravindra L. Mehta, MD Division of Nephrology-Hypertension Department of Medicine, University of California 200 West Arbor Drive, Mail Code 8342, San Diego, CA 92103 (USA) E-Mail [email protected]
Extrarenal environment
Kidney Hemodynamics/ endothelial function
Color version available online
Genetics/ epigenetics
Tubular injury/ repair Microenvironment
Cell loss, Endothelial dysfunction, backleak, capillary loss, obstruction vasoconstriction
Inflammation, immune function
Fig. 1. The complex nature of AKI.
Acute kidney injury (AKI) is a rapidly evolving area, and several advances have been made in understanding the mechanisms and pathways of AKI and its effects on other organs. The recent identification of biomarkers has provided new tools and techniques to characterize this disorder. The complex nature of AKI, including genetics and epigenetic changes, the influence of the environment, and, more importantly, intrinsic kidney-related mechanisms that contribute to the pathophysiology of AKI, offers challenging perspectives for clinical and translational research approaches (fig. 1). This issue summarizes the
118
Nephron Clin Pract 2014;127:117–118 DOI: 10.1159/000363253
proceedings of the 5th Preconference Symposium of the 19th Annual Continuous Renal Replacement Therapy Meeting held in San Diego, Calif., USA, on Tuesday, March 4, 2014, sponsored by the University of Alabama at Birmingham (UAB)-University of California San Diego (UCSD) O’Brien Center for Acute Kidney Injury Research. The UAB-UCSD O’Brien Center has played a major role in the development of scientific resources for investigators in the field of AKI-related research by identifying emerging trends and technologies and pursuing these opportunities through the enhancement of core resources and educational outreach to the research base through workshops and seminars. The overall goal of this symposium was to provide a comprehensive review of the most recent developments in the field and describe emerging knowledge from basic and translational research. The meeting included 30 invited experts from around the world, and over 100 participants were in attendance. Symposium sessions focused on molecules, mechanisms and targets, translational research, improving outcomes, and biomarkers. Results from clinical trials were discussed to define the best strategies for the effective management of patients and to define the criteria for future studies.
Acknowledgment The work was supported by NIH UAB-UCSD O’Brien Center grant P30 DK079337.
Mehta /Sanders /Agarwal
Copyright: S. Karger AG, Basel 2014. Reproduced with the permission of S. Karger AG, Basel. Further reproduction or distribution (electronic or otherwise) is prohibited without permission from the copyright holder.
Published online: September 24, 2014
Changing Paradigms in Acute Kidney Injury: From Mechanisms to Management – Proceedings of the 5th Annual UAB-UCSD O’Brien Center Symposium (San Diego, Calif., USA, March 4, 2014) Ravindra L. Mehta a Paul W. Sanders b, c Anupam Agarwal b, c
a
Division of Nephrology-Hypertension, Department of Medicine, University of California San Diego, San Diego, Calif., and b Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, and c Birmingham Veterans Administration Medical Center, Birmingham, Ala., USA
Contributions of These Proceedings 1 Kasimsetty SG, DeWolf SE, Shigeoka AA, McKay DB: Regulation of TLR2 and NLRP3 in primary murine renal tubular epithelial cells. Nephron Clin Pract 2014;127:119–123. 2 Ince C: The central role of renal microcirculatory dysfunction in the pathogenesis of acute kidney injury. Nephron Clin Pract 2014;127:124–128. 3 Johnson ACM, Zager RA: Renal cortical pyruvate as a potentially critical mediator of acute kidney injury. Nephron Clin Pract 2014;127:129–132. 4 Vallon V: Do tubular changes in the diabetic kidney affect the susceptibility to acute kidney injury? Nephron Clin Pract 2014;127: 133–138. 5 Noel S, Martina-Lingua MN, Bandapalle S, Pluznick J, Hamad ARA, Peterson DA, Rabb H: Intestinal microbiota-kidney cross talk in acute kidney injury and chronic kidney disease. Nephron Clin Pract 2014;127:139–143. 6 Peters E, Masereeuw R, Pickkers P: The potential of alkaline phosphatase as a treatment for sepsis-associated acute kidney injury. Nephron Clin Pract 2014;127:144–148.
7 Nourbakhsh N, Singh P: Role of renal oxygenation and mitochondrial function in the pathophysiology of acute kidney injury. Nephron Clin Pract 2014;127:149–152. 8 Gigliotti JC, Okusa MD: The spleen: the forgotten organ in acute kidney injury of critical illness. Nephron Clin Pract 2014;127:153– 157. 9 Shin HJ, McCullough PA: Focus on lipids: high-density lipoprotein cholesterol and its associated lipoproteins in cardiac and renal disease. Nephron Clin Pract 2014;127:158–164. 10 Ball T, McCullough PA: Statins for the prevention of contrast-induced acute kidney injury. Nephron Clin Pract 2014;127:165–171. 11 Garzotto F, Zanella M, Ronco C: The evolution of pediatric continuous renal replacement therapy. Nephron Clin Pract 2014; 127:172–175. 12 Devarajan P, Murray P: Biomarkers in acute kidney injury: are we ready for prime time? Nephron Clin Pract 2014;127:176–179. 13 Endre ZH: Using biomarkers for acute kidney injury: barriers and solutions. Nephron Clin Pract 2014;127:180–184. 14 Srisawat N, Murugan R, Kellum JA: Repair or progression after AKI: a role for biomarkers? Nephron Clin Pract 2014;127:185–189.
The Symposium was supported by NIH UAB-UCSD O‘Brien Center grant P30 DK079337.
© 2014 S. Karger AG, Basel 1660–2110/14/1274–0117$39.50/0 E-Mail [email protected] www.karger.com/nec
Ravindra L. Mehta, MD Division of Nephrology-Hypertension Department of Medicine, University of California 200 West Arbor Drive, Mail Code 8342, San Diego, CA 92103 (USA) E-Mail [email protected]
Extrarenal environment
Kidney Hemodynamics/ endothelial function
Color version available online
Genetics/ epigenetics
Tubular injury/ repair Microenvironment
Cell loss, Endothelial dysfunction, backleak, capillary loss, obstruction vasoconstriction
Inflammation, immune function
Fig. 1. The complex nature of AKI.
Acute kidney injury (AKI) is a rapidly evolving area, and several advances have been made in understanding the mechanisms and pathways of AKI and its effects on other organs. The recent identification of biomarkers has provided new tools and techniques to characterize this disorder. The complex nature of AKI, including genetics and epigenetic changes, the influence of the environment, and, more importantly, intrinsic kidney-related mechanisms that contribute to the pathophysiology of AKI, offers challenging perspectives for clinical and translational research approaches (fig. 1). This issue summarizes the
118
Nephron Clin Pract 2014;127:117–118 DOI: 10.1159/000363253
proceedings of the 5th Preconference Symposium of the 19th Annual Continuous Renal Replacement Therapy Meeting held in San Diego, Calif., USA, on Tuesday, March 4, 2014, sponsored by the University of Alabama at Birmingham (UAB)-University of California San Diego (UCSD) O’Brien Center for Acute Kidney Injury Research. The UAB-UCSD O’Brien Center has played a major role in the development of scientific resources for investigators in the field of AKI-related research by identifying emerging trends and technologies and pursuing these opportunities through the enhancement of core resources and educational outreach to the research base through workshops and seminars. The overall goal of this symposium was to provide a comprehensive review of the most recent developments in the field and describe emerging knowledge from basic and translational research. The meeting included 30 invited experts from around the world, and over 100 participants were in attendance. Symposium sessions focused on molecules, mechanisms and targets, translational research, improving outcomes, and biomarkers. Results from clinical trials were discussed to define the best strategies for the effective management of patients and to define the criteria for future studies.
Acknowledgment The work was supported by NIH UAB-UCSD O’Brien Center grant P30 DK079337.
Mehta /Sanders /Agarwal
Copyright: S. Karger AG, Basel 2014. Reproduced with the permission of S. Karger AG, Basel. Further reproduction or distribution (electronic or otherwise) is prohibited without permission from the copyright holder.
