Journal article
Intensive Care Unit–Acquired Weakness in Patients With Acute Kidney Injury: A Contemporary Review
American journal of kidney diseases, Vol.81(3), pp.336-351
03/2023
DOI: 10.1053/j.ajkd.2022.08.028
PMCID: PMC9974577
PMID: 36332719
Abstract
Acute kidney injury (AKI) and intensive care unit–acquired weakness (ICU-AW) are 2 frequent complications of critical illness that, until recently, have been considered unrelated processes. The adverse impact of AKI on ICU mortality is clear, but its relationship with muscle weakness—a major source of ICU morbidity—has not been fully elucidated. Furthermore, improving ICU survival rates have refocused the field of intensive care toward improving long-term functional outcomes of ICU survivors. We begin our review with the epidemiology of AKI in the ICU and of ICU-AW, highlighting emerging data suggesting that AKI and AKI treated with kidney replacement therapy (AKI-KRT) may independently contribute to the development of ICU-AW. We then delve into human and animal data exploring the pathophysiologic mechanisms linking AKI and acute KRT to muscle wasting, including altered amino acid and protein metabolism, inflammatory signaling, and deleterious removal of micronutrients by KRT. We next discuss the currently available interventions that may mitigate the risk of ICU-AW in patients with AKI and AKI-KRT. We conclude that additional studies are needed to better characterize the epidemiologic and pathophysiologic relationship between AKI, AKI-KRT, and ICU-AW and to prospectively test interventions to improve the long-term functional status and quality of life of AKI survivors.
Details
- Title: Subtitle
- Intensive Care Unit–Acquired Weakness in Patients With Acute Kidney Injury: A Contemporary Review
- Creators
- J. Pedro Teixeira - University of New MexicoKirby P. Mayer - University of KentuckyBenjamin R. Griffin - University of IowaNaomi George - University of New MexicoNathaniel Jenkins - Department of Health and Human Physiology, University of Iowa, Iowa City, IowaC. Anil Pal - Division of Nephrology, Department of Internal Medicine, University of New Mexico, Albuquerque, New MexicoFelipe González-Seguel - Servicio de Medicina Física y Rehabilitación, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, ChileJavier A. Neyra - University of Alabama at Birmingham
- Resource Type
- Journal article
- Publication Details
- American journal of kidney diseases, Vol.81(3), pp.336-351
- DOI
- 10.1053/j.ajkd.2022.08.028
- PMID
- 36332719
- PMCID
- PMC9974577
- NLM abbreviation
- Am J Kidney Dis
- ISSN
- 0272-6386
- eISSN
- 1523-6838
- Publisher
- Elsevier Inc
- Language
- English
- Electronic publication date
- 11/02/2022
- Date published
- 03/2023
- Academic Unit
- Center for Social Science Innovation; Injury Prevention Research Center; Nephrology; Health, Sport, and Human Physiology ; Internal Medicine
- Record Identifier
- 9984362757302771
Metrics
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