Intensive Care Unit-Acquired Weakness in Patients With Acute Kidney Injury: A Contemporary Review

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dc.contributor.authorTeixeira, Pedro
dc.contributor.authorMayer, Kirby
dc.contributor.authorGriffin, Benjamin
dc.contributor.authorGeorge, Naomi
dc.contributor.authorJenkins, Nathaniel
dc.contributor.authorPal, Anil
dc.contributor.authorGonzález, Felipe
dc.contributor.authorNeyra, Javier
dc.date.accessioned2023-03-21T13:37:19Z
dc.date.available2023-03-21T13:37:19Z
dc.date.issued2022
dc.description.abstractAcute 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.
dc.description.versionVersión publicada
dc.identifier.citationTeixeira JP, Mayer KP, Griffin BR, George N, Jenkins N, Pal CA, González-Seguel F, Neyra JA. Intensive Care Unit-Acquired Weakness in Patients With Acute Kidney Injury: A Contemporary Review. Am J Kidney Dis. 2023 Mar;81(3):336-351. doi: 10.1053/j.ajkd.2022.08.028
dc.identifier.doihttps://doi.org/10.1053/j.ajkd.2022.08.028
dc.identifier.urihttps://repositorio.udd.cl/handle/11447/7117
dc.language.isoen
dc.subjectICU-acquired weakness
dc.subjectIndex Words
dc.subjectAcute kidney injury (AKI)
dc.subjectAcute renal failure (ARF)
dc.subjectContinuous kidney replacement therapy (CKRT)
dc.subjectContinuous renal replacement therapy (CRRT)
dc.subjectCritical illness myopathy
dc.subjectIntensive care unit (ICU)
dc.subjectMuscle atrophy
dc.subjectMuscle wasting
dc.subjectPhysical rehabilitation
dc.subjectPost-intensive care syndrome (PICS)
dc.titleIntensive Care Unit-Acquired Weakness in Patients With Acute Kidney Injury: A Contemporary Review
dc.typeArticle
dcterms.accessRightsAcceso abierto
dcterms.sourceAmerican journal of kidney diseases : the official journal of the National Kidney Foundation

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