Acute kidney injury, acute kidney disease and chronic kidney disease: challenges and research perspectives

Acute kidney injury (AKI) and chronic kidney disease (CKD) are interconnected, with AKI often leading to CKD and vice versa. Despite research advances, their causal relationship in clinical settings remains unclear. Inflammation, oxidative stress and maladaptive repair are key factors in AKI's progression to CKD. AKI episodes may hasten CKD progression, influenced by demographics, comorbidities and treatment factors like blood pressure control. This underscores the need for careful management to prevent long-term damage. Prospective cohort studies addressing confounding factors are essential to understanding AKI's impact on CKD. These studies should use precise definitions and measurements to clarify causal pathways and risk factors. Investigating asymptomatic AKI in the general population and CKD patients could offer insights into progression mechanisms and prevention strategies. Understanding the interplay of AKI and CKD is crucial for developing interventions and improving outcomes, making it a scientific and public health priority.