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Open research questions in Acute Kidney Injury Research

51 unresolved questions extracted from the limitations and future-work sections of 342 Acute Kidney Injury Research papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • Background The optimal timing of liberation from continuous renal replacement therapy (CRRT) in adults with acute kidney injury (AKI) remains uncertain.

    Prediction model for successful liberation from continuous renal replacement therapy in patients with acute kidney injury: development and temporal validation · 2026 · DOI

  • Background/Objectives: Intra-abdominal hypertension (IAH) is a common but under-recognized condition in critically ill patients and is associated with adverse outcomes, particularly acute kidney injury (AKI) and mortality.

    Association of Serial Intra-Abdominal Pressure Measurements with Renal Outcomes and Mortality in Critically Ill Adults · 2026 · DOI

  • It demonstrates that preoperative lipid-lowering apheresis can safely manage metabolic barriers to surgery in complex ESRD patients, potentially expanding the management options for high-risk cardiovascular cases where medical therapy alone is insufficient.

    Preoperative Therapeutic Plasma Exchange for Severe Hypertriglyceridemia-Associated Myocardial Infarction in a Chronic Hemodialysis Patient Undergoing Urgent Coronary Artery Bypass Grafting: A Case Report · 2026 · DOI

  • We cannot conclude that changing CCI patient’s UCR trajectory (for example, through an intervention) will necessarily improve outcomes; that remains to be tested in future studies.

    Association between urea-to-creatinine ratio trajectories and clinical outcomes in chronic critical illness patients: a retrospective cohort study · 2026 · DOI

  • Future research should focus on validating our prediction model in a larger and more diverse population of critically ill patients, including those with different etiologies of sepsis and respiratory failure. Developing a more comprehensive prediction model that incorporates a broader range of potential risk factors for AKI would also be beneficial. Additionally, prospective studies are needed to evaluate the impact of using our prediction model to guide clinical decision-making and its effect on relevant clinical outcomes, such as the incidence and severity of AKI, the need for renal replacement therapy, and overall mortality. „Conclusion Our prediction model, based on readily available clinical and laboratory data, can accurately predict AKI and it severity in critically ill ventilated patients with nonkidney organ dysfunction. This model can be used to identify patients at risk and allow for timely intervention, potentially improving outcomes. „Acknowledgements The authors would like to express their sincere gratitude to the medical undergraduate interns and social service interns from Hospital H+ Querétaro and Hospital Civil de Guadalajara for their invaluable assistance with data collection and organization. We also extend our special thanks to Dra. Alina Arechiga for her support and insightful contributions to this research. Finally, we would like to acknowledge the dedication and hard work of all the clinical and nursing staff at both Hospital H+ Querétaro and Hospital Civil de Guadalajara, whose commitment to patient care made this study possible. „Author contributions JJZ. and AVR designed the study. JJZ collected the data. JJZ, JSCI, AVR. analyzed the data. JJZ, AVR, JSCI. wrote the manuscript. All authors read and approved the final manuscript. „Conflict of interest None to declare. „Funding This study was not supported by any sponsor or funder. „References 1. Molitoris BA. Low-Flow Acute Kidney Injury: The Pathophysiology of Prerenal Azotemia, Abdominal Compartment Syndrome, and Obstructive Uropathy. Clin J Am Soc Nephrol 2022; 17: 1039–1049. 2. Lee SA, Cozzi M, Bush EL, et al. Distant Organ Dysfunction in Acute Kidney Injury: A Review. Am J Kidney Dis 2018; 72: 846– 856. 3. Lysak N, Bihorac A, Hobson C. Mortality and cost of acute and chronic kidney disease after cardiac surgery. Curr Opin Anaesthesiol 2017; 30: 113–117. 4. Matsuura R, Doi K, Hamasaki Y, et al. RRT Selection for AKI Patients With Critical Illness. Semin Nephrol 2020; 40: 498– 505. 5. Kuwabara S, Goggins E, Okusa MD. The Pathophysiology of Sepsis-Associated AKI. Clin J Am Soc Nephrol 2022; 17: 1050– 1069. 6. Achanti A, Szerlip HM. Acid-Base Disorders in the Critically Ill Patient. Clin J Am Soc Nephrol 2023; 18: 102–112. 7.

    Prediction of acute kidney injury in mechanically ventilated patients with COVID-19-related septic shock: An exploratory analysis of non-renal organ dysfunction markers · 2026 · DOI

  • To overcome current limitations and harness the potential of NGAL, research is moving in several directions. A key direction is to investigate specific NGAL isoforms (e.g., the kidney-specific monomer the inflammatory dimer or the NGAL/MMP-9 complex) and develop assays capable of distinguishing between them, which could lead to significant improvements in specificity. versus Another promising approach is to combine NGAL with other markers of renal injury (such as KIM-1, IL-18 and Cystatin C) or functional markers to obtain a more comprehensive and accurate assessment of renal status [1,17].

    The Importance of Neutrophil Gelatinase-Associated Lipocalin (NGAL) in Monitoring Patients with Renal Transplantation · 2025 · DOI

  • Current Status in Clinical Guidelines eGFR, assessment Currently, KDIGO guidelines for monitoring renal transplant patients are primarily based on SCr, of and albuminuria/proteinuria ratio. Renal biopsies are usually performed based on specific clinical. Currently, or laboratory KDIGO guidelines renal transplant patients are primarily based on SCr, of eGFR, albuminuria/proteinuria. Renal biopsies are usually performed based on specific clinical or laboratory indications [16,21]. for monitoring assessment indications and Despite promising research and FDA approval of some NGAL assays, it is not yet a universally adopted routine biomarker in transplant patient monitoring guidelines. Its use is generally more common in research settings or specialized centers with expertise in the field. Thus, a significant gap exists between the promise demonstrated by NGAL in research and its widespread integration into current clinical guidelines and practice. This gap is likely due to unresolved issues, such as the lack of specificity the absence of universally accepted and standardized thresholds, and, perhaps most large-scale importantly, intervention conclusively demonstrate the effectiveness of NGAL-guided management in improving long-term clinical outcomes. For NGAL to move from the status of a " promising biomarker " to that of a "standard of care" tool in monitoring transplant patients, future research must focus not only on confirming its diagnostic or prognostic accuracy but especially on demonstrating its clinical utility—that is, how the use of NGAL can beneficially alter patient management and improve patient-relevant outcomes.

    The Importance of Neutrophil Gelatinase-Associated Lipocalin (NGAL) in Monitoring Patients with Renal Transplantation · 2025 · DOI

  • Various strategies are proposed to attenuate CSA-AKI, including extracorporeal blood purification (EBP), but little is known about the effect of EBP through an acrylonitrile-sodium methallylsulfonate/polyethyleneimine membrane during CPB.

    Extracorporeal Blood Purification and Acute Kidney Injury in Cardiac Surgery · 2024 · DOI

  • Advances in sub-phenotyping of sepsis and AKI and clinical trial design offer unprecedented opportunities to fill gaps in knowledge and generate better evidence for improving the outcome of critically ill patients with SA-AKI.

    Sepsis-associated acute kidney injury: recent advances in enrichment strategies, sub-phenotyping and clinical trials · 2024 · DOI

  • Although diuresis is a common intervention for fluid overload, the optimal timing of diuretic administration for preventing AKI after cardiac surgery remains unclear.

    The effect of early diuretics administration on acute kidney injury progression after cardiac surgery: a post-hoc analysis of a multicenter retrospective cohort study (BROTHER study) · 2023 · DOI

  • Despite the fact that the exact pathogenesis of the condition still remains unknown, the CIN prophylaxis becomes more and more effective due to better recognition of risk factors and the usage of adequate prevention measures appropriate to the patients' condition.

    Contrast-induced nephropathy (CIN) - epidemiology, risk factors and prevention · 2022 · DOI

  • CONCLUSION: AKI episodes are common among hospitalized patients and are associated with considerable morbidity and mortality, yet they are inadequately documented and probably often escape the attention of the treating physicians.

    The Incidence of Acute Kidney Injury and Associated Hospital Mortality · 2019 · DOI

  • CONTEXT: Although acute renal failure (ARF) is believed to be common in the setting of critical illness and is associated with a high risk of death, little is known about its epidemiology and outcome or how these vary in different regions of the world.

    Acute Renal Failure in Critically Ill Patients<SUBTITLE>A Multinational, Multicenter Study</SUBTITLE> · 2005 · DOI

  • However, the prognostic value of intra-abdominal pressure (IAP) remains incompletely defined.

    Association of Serial Intra-Abdominal Pressure Measurements with Renal Outcomes and Mortality in Critically Ill Adults · 2026 · DOI

  • APN is a potentially serious and often underrecognized cause of AKI following phosphate-containing bowel preparation.

    Acute Phosphate Nephropathy Following Oral Sodium Phosphate Bowel Preparation · 2026 · DOI

  • However, the extent to which global pCO 2 gap accurately reflects regional organ blood flow and whether it maintains its predictive value in assessing hypoperfusion and microcirculatory dysfunction associated with sepsis, remain to be elucidated.

    Renal veno-arterial pCO2 gap fails to detect renal medulla microcirculatory changes in a large animal model of sepsis-associated acute kidney injury · 2026 · DOI

  • The specific pathways and regulatory mechanisms of alpha-calcitriol in acute calcium phosphate nephropathy have not been clearly defined in existing studies.

    Successful treatment of pediatric acute phosphate nephropathy: a case report and literature review · 2026 · DOI

  • Although great advancements have been achieved for treating sepsis-induced AKI, its prognosis and pathophysiology remain unclear.

    Overexpression of HIC1 plays a protective effect on renal cell injury caused by lipopolysaccharide by inhibiting IL-6/STAT3 pathway · 2022 · DOI

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51 open questions have been extracted from the limitations and future-work passages of 342 Acute Kidney Injury Research papers in our library. Each one below links back to the study that raised it, so you can read the original claim in context.

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