INTENSIVE NEPHROLOGY FROM THE PERSPECTIVE OF TRANSLATIONAL RESEARCH: NARRATIVE REVIEW AT THE FRONTIER OF KNOWLEDGE

Authors

Keywords:

Nephrology; Biomarkers; Translational Research

Abstract

Introduction: Intensive nephrology contemplates renal pathologies that affect critically ill patients under intensive care and, as it is an recent area of ​​knowledge, it still demands studies that explore alternatives for diagnosis and treatment, in addition to a better pathophysiological understanding of kidney injuries in this level of care, highlighting opportunities for the application of translational research. Objective: This review aims to delimit the current state of the art and understand where are the frontiers of knowledge in intensive nephrology, in its diagnostic, therapeutic aspects and future perspectives. Methodology: This study is a narrative review that carried out extensive research in the literature, including reference papers and databases (PubMed Medline, Google Academics, Scielo and LILACS), selecting articles with potential application in the community and compiling the results in a structured way. They were used as descriptors in the bases: nephrology, biomarkers, translational research and acute kidney injury and the delimited languages ​​were english and portuguese with a focus on the thresholds of diagnosis, treatment and the expectations of using these fundamentals. Results: Update on biomarkers in evidence, such as Kim-1, in addition to contemporary treatment options for intervention in cell metabolism, protein modulation, prescription of antioxidants or anti-apoptotics, use of new drugs and even current ones discussions of renal replacement therapy in the intensive care setting. Conclusion: This narrative review enabled an understanding of the present moment in intensive nephrology, the use of new biomarkers and the frontiers that need to expand translational research for the benefit of patients.

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Author Biography

Klinger Ricardo Dantas Pinto, Physician at the Hospital of the University of Brasília - Brazil

Master in Clinical Research from Hospital de Clínicas de Porto Alegre.

References

Cohrs RJ, Martin T, Ghahramani P, Bidaut L, Higgins PJ, Shahzad A. Translational Medicine definition by the European Society for Translational Medicine. New Horizons Transl Med [Internet] 2015;2(3):86–8. Disponível em: https://www.sciencedirect.com/science/article/pii/S2307502314000782.

Yu L, Marques IDB, Costa MC, Burdmann EA. Nefrologia Intensiva. Rio de Janeiro: Roca; 2016. 392p.

Kidney Disease improving global outcomes. Clinical Practice Guideline for Acute Kidney Injury. Kidney Int 2012; 2(suppl): 1-138. Disponível em: https://kdigo.org/wp-content/uploads/2016/10/KDIGO-2012-AKI-Guideline-English.pdf.

Veronese FV, Manfro RC, Thomé FS, Barros E. Nefrologia na Prática Clínica. São Paulo: Livraria Balieiro; 2019. 880p.

Ince C. The microcirculation is the motor of sepsis. Critical Care 2005;9(Suppl 4):S13-S19. Disponível em: http://dx.doi.org/10.1186/cc3753.

Zhang CF, Wang HJ, Tong ZH, Zhang C, Wang YS, Yang HQ et al. The diagnostic and prognostic values of serum and urinary kidney injury molecule-1 and neutrophil gelatinase-associated lipocalin in sepsis induced acute renal injury patients. Eur Rev Med Pharmacol Sci 2020 May;24(10):5604-5617. Disponível em: http://dx.doi.org/10.26355/eurrev_202005_21346.

Wu Q, Xiao Z, Pu Y, Zhou J, Wang D, Huang Z et al. TnI and IL-18 levels are associated with prognosis of sepsis. Postgrad Med J 2019 May;95(1123):240-244. Disponível em: https://doi.org/10.1136/postgradmedj-2018-136371.

Leem AY, Park MS, Park BH, Jung WJ, Chung KS, Kim SY et al. Value of Serum Cystatin C Measurement in the Diagnosis of Sepsis-Induced Kidney Injury and Prediction of Renal Function Recovery. Yonsei Med J 2017 May;58(3):604-612. Disponível em: https://doi.org/10.3349/ymj.2017.58.3.604.

Tanabe J, Ogura Y, Nakabayashi M, Nagai Y, Watanabe S, Sugaya T et al. The Possibility of Urinary Liver-Type Fatty Acid-Binding Protein as a Biomarker of Renal Hypoxia in Spontaneously Diabetic Torii Fatty Rats. Kidney Blood Press Res 2019;44(6):1476-1492. Disponível em: https://doi.org/10.1159/000503926.

Endre ZH, Westhuyzen J. Early detection of acute kidney injury: emerging new biomarkers. Nephrology (Carlton) 2008;13(2):91-8. Disponível em: https://doi.org/10.1111/j.1440-1797.2007.00905.x.

De Oliveira Neves FM, Araújo CB, Freitas DF, Arruda BFT, Macêdo Filho LJM, Salles VB et al. Fibroblast growth factor 23, endothelium biomarkers and acute kidney injury in critically-ill patients. J Transl Med 2019;17(121). Disponível em: https://doi.org/10.1186/s12967-019-1875-6.

Kashani K, Khafaji AA, Ardiles T, Artigas A, Bagshaw SM, Bell M et al. Discovery and validation of cell cycle arrest biomarkers in human acute kidney injury. Critical Care 2013;17(1):R25. Disponível em: https://doi.org/10.1186%2Fcc12503.

Cruz J, Cruz HMM, Kirsztajn GM, Oliveira RB, Barros RT. Atualidades em Nefrologia 15. São Paulo: Sarvier; 2018. 459p.

Jiang L, Xu L, Mao J, Li J, Fang L, Zhou Y et al. Rheb/mTORC1 signaling promotes kidney fibroblast activation and fibrosis. J Am Soc Nephrol 2013; 24(7):1114-26. Disponível em: https://doi.org/10.1681/asn.2012050476.

Lazo-Fernández Y, Baile G, Meade P, Torcal P, Martínez L, Ibanez C et al. Kidney-specific genetic deletion of both AMPK α-subunits causes salt and water wasting. Am J Physiol Renal Physiol 2017;312(2):352-365. Disponível em: https://doi.org/10.1152/ajprenal.00169.2016.

Iwaki T, Bennion BG, Stenson EK, Lynn JC, Otinga C, Djukovic D et al. PPARα contributes to protection against metabolic and inflammatory derangements associated with acute kidney injury in experimental sepsis. Physiol Rep 2019; 7(10):e14078. Disponível em: https://doi.org/10.14814/phy2.14078.

Hu J, Qiao J, Yu Q, Liu B, Zhen J, Liu Y et al. Role of SIK1 in the transition of acute kidney injury into chronic kidney disease. JTranslMed 2021;19(69). Disponível em: https://doi.org/10.1186/s12967-021-02717-5.

Chen YT, Tsai TH, Yang CC, Sun CK, Chang LT, Chen HH et al. Exendin-4 and sitagliptin protect kidney from ischemia-reperfusion injury through suppressing oxidative stress and inflammatory reaction. J Transl Med 2013;11(270). Disponível em: https://doi.org/10.1186/1479-5876-11-270.

Ying J, Wu J, Zhang Y, Han Y, Qian X, Yang Q et al. Ligustrazine suppresses renal NMDAR1 and caspase-3 expressions in a mouse model of sepsis-associated acute kidney injury. Mol Cell Biochem 2020;464(1-2):73-81. Disponível em: https://doi.org/10.1007/s11010-019-03650-4.

Wang AG, Diamond M, Waddell J, MaKenna MC. Effect of Acetyl-L-carnitine Used for Protection of Neonatal Hypoxic-Ischemic Brain Injury on Acute Kidney Changes in Male and Female Rats. Neurochem Res 2019;44(10):2405-2412. Disponível em: https://doi.org/10.1007/s11064-019-02807-3.

Hu MC, Shi M, Zhang J, Quinones H, Kuro-o M, Moe OW et al. Klotho deficiency is an early biomarker of renal ischemia-reperfusion injury and its replacement is protective. Kidney Int 2010;78(12):1240-51.

Disponível em: https://doi.org/10.1038/ki.2010.328.

Si Y, Bao H, Han L, Shi H, Zhang Y, Xu L et al. Dexmedetomidine protects against renal ischemia and reperfusion injury by inhibiting the JAK/STAT signaling activation. J Transl Med 2013;11(141). Disponível em: http://www.translational-medicine.com/content/11/1/141.

Duann P, Li H, Lin P, Tan T, Wang Z, Chen K et al. MG53-mediated cell membrane repair protects against acute kidney injury. Sci Transl Med 2015;7(279):279ra36. Disponível em: https://doi.org/10.1126/scitranslmed.3010755.

Published

2023-12-28

How to Cite

Pinto, K. R. D. (2023). INTENSIVE NEPHROLOGY FROM THE PERSPECTIVE OF TRANSLATIONAL RESEARCH: NARRATIVE REVIEW AT THE FRONTIER OF KNOWLEDGE. Práticas E Cuidado: Revista De Saúde Coletiva, 4, e16525. Retrieved from https://www.revistas.uneb.br/index.php/saudecoletiva/article/view/16525

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Section

Revisão de Literatura