Microbial menace to kidney health: A review of the role of infections in acute kidney injury

Abstract

Acute kidney injury (AKI) of infectious aetiology is a complex condition that requires a comprehensive microbiological evaluation. This  includes sepsis workup, evaluation of urinary tract infection (UTI), assessment for viral, fungal, and bacterial infections, consideration of  the patient's microbiome, and vigilance towards antibiotic toxicity. Advanced molecular diagnostic tools such as metagenomic  sequencing and rapid point-of-caretesting, may offer future advances in accurate and timely identification of infectious aetiologies in AKI.  Careful antibiotic selection, dosing, and duration, taking into account renal function and potential toxicity, are crucial in the era of  increasing antibiotic resistance. The information presented in this review were obtained through a thorough literature search using  relevant search terms on various databases including PubMed, Embase, and Cochrane Library. The review identified bacterial sepsis and  UTI as common infectious syndromes associated with AKI, but also emphasized the need to consider other infectious aetiologies  including viral, fungal and parasitic infections in certain clinical scenarios. The review also discussed the potential role of advanced  molecular diagnostic tools in identifying infectious aetiologies in AKI and the importance of careful antibiotic selection, dosing, and  duration. In conclusion, a comprehensive microbiological evaluation, coupled with the use of advanced diagnostic techniques and  antibiotic stewardship, is vital for the effective management of AKI from suspected infectious aetiology, which can aid optimize patient  outcomes.