When inflammation goes overboaRd

Insights into a dysregulated immune response

Acute kidney injury (AKI)

AKI—a sudden and temporary loss of kidney function—can be caused by a wide range of conditions, such as COVID-19, sepsis, severe trauma, and surgery and can lead to end stage renal disease1-4. In critically-ill patients with AKI, a dysregulated immune response can lead to hyperinflammation. This aggressive response contributes to significant morbidity, including prolonged length of stay in the ICU, increased reliance on dialysis & mechanical ventilation, and increased hospital costs5.  Damage resulting from this dysregulated response in AKI can progress to other organs, such as the heart or liver.  Multi-organ dysfunction (or even failure) can lead to worse outcomes, including cardiovascular events and an increased risk of death6, 7.  Even after resolution, these patients may face chronic kidney disease (CKD), end-stage renal disease (ESRD) requiring dialysis, or other complications which can further contribute to increased healthcare utilization costs8-11.

Pediatric AKI

In critically ill patients, stopping this dysregulated immune response can be crucial to improve outcomes


1.      Malkina A. Acute kidney injury (AKI). Merck Manual Professional Version. 2020. Accessed January 5, 2021.

2.      Hassanein M, Radhakrishnan Y, Sedor J, et al. Cleveland Clinic Journal of Medicine. 2020;87(10):619-631. 

3.      Yap SC, Lee HT.  Anesthesiology. 2012;116(5):1139-1148.

4.      Hsu RK, Hsu C.Semin Nephrol. 2016;36(4):283-292. 

5.      Collister D, et al. Clin J Am Soc Nephrol. 2017;12(11):1733-1743.

6.      Doyle JF, Forni LG. Crit Care. 2016;20(1):188.

7.      Armutcu F. Inflamm Res. 2019;68(10):825-839.

8.      Cerda J, et al. Clin J Am Soc Nephrol. 2015;10(10):1859-1867.

9.      Godeau E, et al. Case Rep Crit Care. 2019;7953141.

10.    Wu VC, et al. J Am Soc Nephrol. 2014;25(3):595-605.

11.    Wu VC, et al. J Am Heart Assoc. 2014;3(4):e000933.