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      Role of Renal Hypoxia in the Progression From Acute Kidney Injury to Chronic Kidney Disease

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      Seminars in Nephrology
      Elsevier BV

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          Abstract

          Over the last 20 years, there has been an increased appreciation of the long-term sequelae of acute kidney injury (AKI) and the potential development of chronic kidney disease (CKD). Several pathophysiological features have been proposed to mediate the AKI to CKD progression including maladaptive alterations in tubular, interstitial, inflammatory and vascular cells. These alterations likely interact to culminate in the progression to CKD. In this article we focus primarily on evidence of vascular rarefaction secondary to AKI, and the potential mechanisms by which rarefaction occurs in relation to other alterations in tubular and interstitial compartments. We further focus on the potential that rarefaction contributes to renal hypoxia. Consideration the role of hypoxia in the AKI to CKD transition focuses on experimental evidence of persistent renal hypoxia following AKI and experimental maneuvers to evaluate the influence of hypoxia, per se, in progressive disease. Finally, consideration of methods to evaluate hypoxia in patients is provided with the suggestion that non-invasive measurement of renal hypoxia may provide insight into progression in post AKI patients.

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          Author and article information

          Journal
          Seminars in Nephrology
          Seminars in Nephrology
          Elsevier BV
          02709295
          November 2019
          November 2019
          : 39
          : 6
          : 567-580
          Article
          10.1016/j.semnephrol.2019.10.006
          6917038
          31836039
          7475c50e-9207-4608-93e3-8729b9376360
          © 2019

          https://www.elsevier.com/tdm/userlicense/1.0/

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