Acute kidney injury (AKI) is a common critical illness in clinical practice, with complex etiologies, acute onset, and rapid progression. It not only significantly increases the mortality rate of patients, but also may progress to chronic kidney disease. Currently, its incidence remains high, and improving early diagnosis rate and treatment efficacy is a major clinical challenge. Artificial intelligence (AI), with its powerful data processing and analysis capabilities, is developing rapidly in medical field, providing new ideas for disease diagnosis and treatment, and showing great potential in revolutionizing the early diagnosis, condition assessment, and treatment decision-making models in the AKI field. This article will review the application progress of AI in AKI prediction, condition assessment, and treatment decision-making, so as to provide references for clinicians and promote the further application and development of AI in the AKI field.
Chronic kidney disease (CKD) has been highlighted as one of the most important public health problems due to sharply climbing incidence and prevalence. To efficiently attenuate the disease burden and improve the disease management, not only active and effective treatment should be administrated, but also comprehensive follow-up nursing management with innovative and evolving spirits should be implemented. Thus dynamic changes of diseases could be acquired in time and patients are under appropriate medical instruction as soon as possible. This editorial is based on quickly developing medical big data resources and advanced internet techniques, from both aspects of patients and health care providers, briefly talking about integrated management strategy of CKD and its future development in China.
Continuous renal replacement therapy (CRRT) is one of the major treatments for critically ill patients. With the development of information technology, the informatization and artificial intelligent of CRRT has received wide attention, which has promoted the optimization of CRRT in terms of workflow, teaching method as well as scientific research. Benefiting from the big data generated, artificial intelligence is expected to be applied in the precision treatment, quality control, timing of intervention, as well as prognosis assessment in severe AKI, so as to ultimately improve the therapeutic effect of CRRT among critically ill patients. This paper summarizes the information construction of CRRT and the research progress of artificial intelligence, which can be used as a reference for practitioners in kidney disease, critical medicine, emergency medicine and other related fields.
ObjectiveTo investigate the role of multiple disciplinary team (MDT) during surgical treatment of renal secondary hyperparathyroidism (SHPT), and identify management points of Departments of Nephrology and Endocrinology.MethodsThe data of patients with chronic kidney disease undergoing surgical treatment for SHPT in West China Hospital of Sichuan University between January 2009 and December 2018 were retrospectively collected. We explained the surgical treatment of MDT in the management of renal SHPT, and compared the changes before and after the establishment of MDT.ResultsA total of 187 patients including 101 males and 86 females were enrolled, with an average age of (47.60±11.28) years old and median dialysis vintage of 7 years. Under MDT, the number of patients with parathyroidectomy increased [(8.50±5.10) vs. (59.50±2.12) patients/year, P<0.001] and the completion rate of preoperative examinations were greatly improved (P<0.001). The success rate of surgery was also increased (86.8% vs. 97.5%, P=0.010). Proportion of patients who were admitted to the Department of Nephrology was significantly increased (39.7% vs. 84.9%, P<0.001). Most patients after surgery were transferred to the Department of Endocrinology (5.9% vs. 77.3%, P<0.001) to manage postoperative complications and metabolic bone disease, and thus normalized the management of SHPT.ConclusionsThe MDT contributes to management of renal SHPT, which is worthy of popularization and spreading. The management of internal medicine departments during surgical treatment of SHPT based on MDT is important, because they can be helpful to complete preoperative examinations and preoperative preparation as well as to alleviate postoperative complications.
Blood purification, as a critical medical intervention for renal function replacement, metabolic waste clearance, and homeostasis maintenance, relies heavily on the optimization of therapeutic solutions to ensure clinical efficacy. In recent years, significant advancements have been made in the formulation design, biocompatibility, and clinical outcomes of blood purification solutions, driven by progress in clinical medicine and biomedical engineering. This article systematically elaborates on the latest research developments in key therapeutic solutions, including continuous renal replacement therapy replacement fluids, hemodialysis dialysate, hemodialysis catheter lock solutions, and peritoneal dialysate. By synthesizing current evidence, the aim is to offer scientific guidance for clinicians in selecting optimal treatment regimens while exploring future directions and emerging trends in the development of blood purification solutions.
Sepsis is a common clinical critical illness, which often leads to multiple organ damage including the kidney damage, which is difficult to treat and has a high mortality rate. In recent years, extracorporeal blood purification therapy has made some progress in the field of sepsis. There are a variety of blood purification modes to choose, but there is still no unified standard for the initiation timing of blood purification therapy. Clinicians mainly evaluate the indicators and the initiation timing of blood purification therapy according to the patient’s needs for renal function replacement and/or inflammatory mediator clearance. This article mainly summarizes and discusses the initiation timing of blood purification therapy in sepsis.