This article has been reviewed according to Science X's editorial process and policies. Editors have highlighted the following attributes while ensuring the content's credibility:


peer-reviewed publication

trusted source


New research: Acute kidney damage spreads over time

New research: Acute kidney damage spreads over time
A model of partial ischemia-reperfusion injury (partial IRI). a Schematic drawing of the partial IRI model. b, c Urinary albumin/creatinine ratio and glomerular filtration rate (GFR) from sham and partial IRI mice (b: n = 3 and 4 mice and c: n = 4 and 8 mice for sham and partial IRI, respectively); mean ± SEM with scatterplot. Statistical test: repeated measurement two-way ANOVA, factors: treatment and days from treatment, post-hoc analysis: multiple comparisons, Bonferroni correction (Supplementary Extended Statistics.b). d Representative stereomicroscope photos of a mouse kidney before and during renal artery branch occlusion for 21 min and after abdominal imaging window (AIW) implantation upon reperfusion. Ischemic and perfused regions were clearly identifiable until reperfusion. AIW implantation was performed on the interphase between ischemic (IR), non-ischemic (Not-IR) regions, and the area in between (Mid). Inlet: Arterial bifurcation (V: renal vein, A: renal artery, K: kidney. Arrow indicates bifurcation). e In vivo 2-photon images acquired 2 h after partial IRI, identified IR, Mid, and Not-IR regions. Scale bar: 50 μm. Note marked reduction of blue autofluorescence in propidium iodide (PI)+ tubule cells (inlet, scale bar: 30 μm). f Necrotic injury distribution in sham and different injury regions of partial IRI kidneys clustered by percentage of segments with indicated threshold of PI+ nuclei (% of total nuclei/ segment). g Volumetric quantification of PI+ nuclei (% of total nuclei/ segment), (n = 123, 334, and 263 segments from 5, 7, and 6 mice for Not-IR, Mid, and IR, respectively, and 360 segments from 3 Sham mice); mean ± 95% CI with scatterplot. Statistical test: linear mixed-effect model, p-values from two-sided test (Supplementary Extended Statistics.c). h In vivo 2-photon image acquired 6 h after partial IRI, displaying luminal accumulation of PI+ cells. Scale bar: 50 μm. *: p < 0.05; **: p < 0.01; ***: p < 0.001. Credit: Nature Communications (2023). DOI: 10.1038/s41467-023-40037-y

When our kidneys are acutely damaged, it can cause necrotic injury, which is the death of cells in the kidney. A new study from Aarhus University has now found that the cell damage spreads over several days after the immediate injury, affecting a larger area of the kidneys.

Assistant Professor at the Department of Biomedicine, Ina Maria Schiessl, who is one of the researchers behind the study, which has recently been published in Nature Communications, explains, "Our study confirms that acute kidney injury, after temporary interruption of organ blood supply, causes significant necrotic injury in the kidneys. However, by repeatedly imaging the same areas of the kidney over a time course of several weeks in living mice, we now show that there is significant injury propagation into previously uninjured areas of the kidney, causing structural damage in those areas."

And these findings are significant for how we treat patients, she explains. "Our data document pronounced spread of the initial injury over the first few days after acute kidney injury. This suggests a previously unknown time window for intervention measures to limit further injury and disease progression in the kidneys."

Can cause permanent kidney damage

Acute kidney injury is a risk factor for chronic kidney disease. In fact, patients with acute kidney injury have an up to 8-times higher risk of developing chronic kidney disease later, even if they initially experience full functional recovery. Chronic kidney disease affects more than 10% of the world's population and causes a significant burden on respective patients and health care systems. There is no cure for chronic kidney disease and over time the disease may progress into end stage , leaving patients with only two options: dialysis and kidney transplantation.

Researchers have yet to fully understand the transition from acute kidney injury to chronic kidney disease, and as a result, there are no established intervention measures to halt the progression into . But Schiessl hopes that this study may bring researchers a step closer to understanding how our kidneys are affected when subjected to acute injuries and what role that may play in the development of chronic .

"Our study documented a link between the accumulation of necrotic cell material in the kidney and propagation over time. Future work will need to explore if and how the loss of function and chronic can be halted through targeting or removal of necrotic cell material after ," she says.

She hopes that the findings will result in new studies further exploring the long-term effects of acute injuries to the kidneys.

More information: Luca Bordoni et al, Longitudinal tracking of acute kidney injury reveals injury propagation along the nephron, Nature Communications (2023). DOI: 10.1038/s41467-023-40037-y

Journal information: Nature Communications

Provided by Aarhus University
Citation: New research: Acute kidney damage spreads over time (2023, September 26) retrieved 2 December 2023 from
This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.

Explore further

Low follow-up kidney testing after hospital discharge with moderate to severe AKI, requires improvement


Feedback to editors