Acute Kidney Injury

A central role for a Nephrologist is the management of patients at risk for or who develop acute kidney injury (AKI). AKI, even of a transient and of relatively minor severity is associated with poor in-hospital outcomes and long-term progression to chronic kidney disease and shortened survival. Until recently, our ability to diagnose AKI has been delayed because of our reliance on a rise in serum creatinine that lags behind a change in glomerular filtration rate by days. This lack of timely diagnosis of AKI has undermined efforts to develop effective therapeutics to reverse or minimize AKI.

For the past 10 years, I have worked with a start-up company to develop a transdermal, real time monitoring system of glomerular filtration rate (the kidneys ‘vital sign’). The system will likely become commercially available in 2019. However, we at the University of Vermont will start preliminary trials with this technology in 2017. We already have an ongoing project in cardiovascular surgery and are collaborating with investigators at other institutions on contrast associated AKI. We intend to start using the technology for screen transplant donors and to follow the initial course following transplantation. This technology, together with the growing availability of injury biomarkers, will give Nephrologists an opportunity to intervene as soon as there is evidence of either a functional or toxic/ischemic compromise of kidney function. Come and join us in this exciting new approach to AKI.