Forward Looking StatementStatements in this press release regarding Akebia Therapeutics, Inc.'s ("Akebia's") strategy, plans, prospects, expectations, beliefs, intentions and goals are forward-looking statements within the meaning of the U.S. The overexpression and urinary excretion of SerpinA3K in animals and patients with AKI and CKD suggest that this protein may have an active role during kidney damage. The Company was founded in 2007 and is headquartered in Cambridge, Massachusetts. of excretion, Primary HCP, nursing, Acute kidney injury care bundles are associated with improved in-hospital mortality rates and reduced risk of progression. All experiments involving animals were conducted in strict accordance with the NIH Guide for the Care and Use of Laboratory Animals and with the Mexican Federal Regulation for animal reproduction, care, and experimentation (NOM-062-ZOO-2001). One limitation of this study is that it was not designed to assess the long-term consequences of AKI but only the short-term ones, such as 24 h after I/R. He has a soiled dressing on his right foot and is a stage III ulcer. medications, allergies, Content Outcome: Practice the role of the professional nurse in promoting quality of care A risk diagnosis is not evidenced by any signs and symptoms, as the problem has not occurred yet and nursing interventions will be directed at the prevention of symptoms. 5000113 and 5000114). -Steamed broccoli Shemies, R.S. 2013 University of Texas at Arlington Page 2 of 2, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, Jones is experiencing sustained shortness of breath and feels, like his heart is pounding. Chronic kidney disease (CKD) or Chronic renal failure (CRF) is characterized by a progressive and irreversible loss of kidney function. The serpin family is composed of 34 members that possess a central domain with three folded beta sheets and 89 alpha helices; their capacity as inhibitors of serine proteases depends on this domain. Loop diuretics are most beneficial when used with thiazide. damage, death. Which of the following actions should Nurse Chris implement first? Post hoc analysis was performed with Tukeys multiple comparisons test. Copyright 2019 by the American Academy of Family Physicians. Further studies are required to address the relevance of SerpinA3K deficiency in different pathological settings, including CKD, diabetic nephropathy, and even immune-mediated nephritis. of previous tests for muscle weakness, Kellum, J.A. Reverse transcription was performed to obtain cDNA. ; Prez-Villalva, R.; Gamba, G.; Snchez-Navarro, A.; Bobadilla, N.A. Mr. Jones is Alert and oriented, extremely short of breath, is Nurse Sam is reviewing Ms. Swisher's EMR with Charge Nurse Robbi. Digoxin level is 0.6. labs be redrawn to ensure all electrolytes are within range, Urinary hydrogen peroxide excretion (UH, Moreover, it has been reported that Sirtuin-1 protects against ROS [, Recently, SerpinA3 has attracted the attention of various research groups due to its multiple canonical and non-canonical roles in several diseases; however, there is not enough evidence on the physiological and pathophysiological role of SerpinA3K in renal tissue [. ; Marquina-Castillo, B.; Gamba, G.; Bobadilla, N.A. slow rate of fluid due to patient being in renal failure and Recently he has been on antibiotics for a stage 3 ulceration. Excess fluid volume is common in patients with CRF because the kidneys are not functioning to remove excess fluids and waste products from the body. MR. Jones was recently discharged from another facility for treatment for his atrial fibrillation and a, type 2 diabetic ulcer on his right foot. chest pH, osmolality, blood, casts, protein, have left out that you have questions about? Pharmacist-led quality-improvement programs reduce nephrotoxic exposures and rates of acute kidney injury in the hospital setting. admitted on 01/08/XX for shortness of breath and weakness. Sodium polystyrene sulfonate. ; Wen, Y.; Li, Z.-L.; Bin Wang, B.; et al. Full Document, watch ATI Real Life Myocardial Infarction Complications and answer the posed questions within the scenario. Course. This is considered one of the earliest signs of impaired renal function. C. obtain consent before central line placement. Which of the following classes of medications should Nurse Sam identify as being prescribed to manage Ms. Swisher's anemia? Follow-up three months after hospitalization is reasonable if renal function is recovered (90% or greater from baseline), with earlier follow-up intervals (at three weeks and then again at three months) for patients with a slower recovery.43 Blood pressure, weight, serum creatinine level, and GFR should be measured at each visit. reduce metabolic rate, Which if the following medications should Nurse Chris anticipate administering? A universal definition and staging system for acute kidney injury proposed by the Kidney Disease: Improving Global Outcomes (KDIGO) group merges the earlier RIFLE (risk of renal dysfunction, injury to the kidney, failure of kidney function, loss of kidney function, end-stage renal disease) and Acute Kidney Injury Network definitions.79 The KDIGO system (Table 27) is used in this article. Jones is experiencing sustained shortness of breath and feels Hyperkalemia can cause muscle weakness, restlessness, cramping, and a slow heart rate. The results presented in this paper have not been published previously in whole or in part. ; Al-Awqati, Q.; Lin, F. FoxO. Liu, X.; Lin, Z.; Zhou, T.; Zong, R.; He, H.; Liu, Z.; Ma, J.-X. Intrinsic renal causes of acute kidney injury are categorized by the location of the injury, most commonly the glomerulus or tubule, and include the interstitial or vascular portions of the kidney.11 Intrinsic acute kidney injury requires early identification and prompt subspecialty consultation. ; Wilson, K.; Patel, B.; Sun, J.; Sartain, C.L. Situation: What is the In the study of adult patients on dialysis, vadadustat achieved the primary and key secondary efficacy endpoint in each of the two INNO2VATE studies, demonstrating non-inferiority to darbepoetin alfa as measured by a mean change in hemoglobin (Hb) between baseline and the primary evaluation period (weeks 24 to 36) and secondary evaluation period (weeks 40 to 52). In addition, the questions listed below must be answered. He is non-compliant in managing his diabetes. No. about? ; Parikh, C.R. Monitor closely. When there is excess fluid, complications can arise including swelling, hypertension, and heart problems. 9: 7815. Prepare the patient for dialysis as indicated.Patients with stage 5 renal failure will require dialysis. A prospective cohort study of acute kidney injury and kidney outcomes, cardiovascular events, and death. Pefanis, A.; Ierino, F.L. Ikizler, T.A. Human SerpinA3 is homologous to SerpinA3K in rodents [, Zhang B. et al. Nurse Chris has documented the assessment findings for Ms. Swisher. imbalances can Immune complexes from systemic illness (e.g., membranoproliferative glomerulonephritis, polyarteritis nodosa) cause acute inflammation and structural damage to the glomeruli. Educate the patient about signs of high potassium and other risks.Patients with CRF are susceptible to hyperkalemia and hyponatremia. Hoste, E.A.J. ; Govil, D.; et al. Real Life scenarios were developed by nurse educators to provide experience with the variety of situations nurses face in real life, without the need for live clinical presence or risk to client safety. Four groups were studied: WT+S, WT+IR, KOSA3+S, and KOSA3+IR. B. fib with a rapid ventricular response w/ signs and symptoms Isotonic crystalloids are preferred over colloids when fluid resuscitation is indicated in patients with acute kidney injury. Gong, L.; He, J.; Sun, X.; Li, L.; Zhang, X.; Gan, H. Activation of sirtuin1 protects against ischemia/reperfusion-induced acute kidney injury. Throughout Europe, more than 200,000 dialysis patients are currently treated for anemia associated with CKD. hypertension, electrolyte References from those sources were also searched. Her nursing career has led her through many different specialties including inpatient acute care, hospice, home health, case management, travel nursing, and telehealth, but her passion lies in educating through writing for other healthcare professionals and the general public. Nurse Chris is preparing to administer furosemide IV bolus for Ms. Swisher. ; Burdmann, E.A. Balanced crystalloids are preferred over 0.9% sodium chloride for fluid resuscitation in critically ill and noncritically ill patients. GI Bleed is defined as any bleeding that occurs within the gastrointestinal tract. Also noted Mr. holistic care. Dialysis nurses are trained to provide hemodialysis or peritoneal dialysis. home health, N4455 Nursing Leadership and Management. Anemia associated with CKD, common in patients on dialysis, is a debilitating condition which may be associated with many adverse clinical outcomes. The optical density was measured with ImageJ. The final stage of CRF is end-stage renal disease (ESRD) which requires dialysis and kidney transplant. About Akebia TherapeuticsAkebia Therapeutics, Inc. is a fully integrated biopharmaceutical company with the purpose to better the lives of people impacted by kidney disease. The inflammatory response activation for the I/R injury was evidenced by the upregulation of, According to the previous findings, the response to hypoxia could be different in the absence of SerpinA3K. No. However, the consequence of SerpinA3K deficiency in basal and in AKI conditions has not been reported. https://www.prnewswire.com/news-releases/akebia-receives-european-commission-approval-for-vafseo-vadadustat-for-the-treatment-of-symptomatic-anaemia-associated-with-chronic-kidney-disease-in-adults-on-chronic-maintenance-dialysis-301807286.html, Do Not Sell My Personal Data/Privacy Policy. Acute kidney injury is a clinical syndrome characterized by a rapid decline in glomerular filtration rate and resultant accumulation of metabolic waste products. related to the situation The antioxidant protection observed was associated with diminished pro-apoptotic signaling. the nurses assessment Fluid restriction is indicated to prevent and reduce fluid overload. Transient response of serpinA3 during cellular stress. Portions of brain, kidney, liver, lung, and heart were homogenized with a lysis buffer (50 mM HEPES pH 7.4, 250 mM NaCl, 5 mM EDTA, 0.1% NP-40) and complete protease inhibitor (Roche, Cat. 1. Feel free to join. Sanchez-Navarro, A.; Gonzlez-Soria, I.; Caldio-Bohn, R.; Bobadilla, N.A. articles published under an open access Creative Common CC BY license, any part of the article may be reused without Purposive Communication Module 2, Leadership and management ATI The leader CASE 1, Toaz - importance of kartilya ng katipunan, Leadership class , week 3 executive summary, I am doing my essay on the Ted Talk titaled How One Photo Captured a Humanitie Crisis https, School-Plan - School Plan of San Juan Integrated School, SEC-502-RS-Dispositions Self-Assessment Survey T3 (1), Techniques DE Separation ET Analyse EN Biochimi 1. This leads to some serious medical problems, like kidney disease, atherosclerosis, metabolic syndrome, and vision damage. Which if the following findings should Nurse Chris identify as an indication that Ms. Swisher needs acute care at this time? Snchez-Navarro, A.; Murillo-De-Ozores, A.R. Then, they were incubated with their respective secondary antibody: anti-rabbit (Sigma, A0545) or anti-mouse (Jackson, 115-035-174). Acute kidney injury (AKI) is where your kidneys suddenly stop working properly. What is the nurses 2. Diabetes is a serious disease. Which of the following interventions should Nurse Chris include? restrictions, monitor labs, with physician; exercise; healthy/balanced diet; ; Ma, J.-X. Bronchial is a chronic disease of the airways that root recur and distressing season of wheezing, breathlessness, chest tightness, also coughing . Acute kidney injury care bundles, a specific set of guideline-based diagnostic and therapeutic interventions, are associated with improved in-hospital mortality rates and reduced risk of progression in observational studies. Chronic Kidney Disease, Fluid Overload, and Diuretics: A Complicated Triangle. buildup in the A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. Nurse Chris is preparing to provide a status update on Ms. Swisher to Dr. Lanzo. 2. AKI normally happens as a complication of another serious illness. ; Siskind, L.J. 9th Edition. Yuen, J.W.-M.; Benzie, I. Hydrogen peroxide in urine as a potential biomarker of whole body oxidative stress. 2. Ortega-Trejo, J.A. following: Mr. Robert Jones, a 60-year-old African American male, was Course Outcome: Apply the nursing process using information technology and evidence- based data in the delivery of competent, culturally sensitive, developmentally . Restrict intake when levels are high or provide additional sources if deficient. Administer diuretics as indicated.Diuretics promote urinary elimination and prevent fluid overload in patients with CRF. His total bilirubin was 2.8, calcium 8.7, WBCs 16.1, hemoglobin 9.3, hematocrit 28.2, and blood glucose 71. urine volume, color, specific gravity, 2. Nurse Sam recognizes that Ms. Swisher's emotional state might also be related to physiological findings and is reviewing Ms. Swisher's EMR. Hyponatremia can cause muscle cramps, nausea, disorientation, and alterations in mental status. ATI: RN Adult Medical Surgical Kidney Disease. NHS. Inhibition of CTGF overexpression in Diabetic Retinopathy by SERPINA3K. Please note that many of the page functionalities won't work as expected without javascript enabled. Important Safety InformationThe full European Summary of Product Characteristics (SPC/SmPC) for Vafseo (vadadustat) will be available from the European Medicines Agency at https://www.ema.europa.eu. A22188, ThermoFisher Scientific, Waltham, MA, USA) following manufacturers instructions. Ischemia, hypoxia, or nephrotoxicity cause ; Bellomo, R.; Cely, C.M. GR. The admitting Describe the action for this classification of, QUESTION 1 When inserting a nasogastric or nasoenteric tube, the patient is assisted to a high-Fowlers position to facilitate _______________ and to prevent _______________. ; data curation, I.G.-S. and N.A.B. The physical examination should focus on evaluating intravascular volume status. Verified questions. the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, A fractional excretion of sodium less than 1% suggests a prerenal cause of acute kidney injury, whereas a value greater than 2% suggests an intrinsic cause. For more details: Forty male mice aged 3 months were included, of which twenty were wild type (WT, (SerpinA3K(+/+, Glomerular filtration rate (GRF) was determined as described before [, Kidney slices of 4 m were stained with periodic acid-Schiff (PAS) to evaluate tubular damage. Impaired urinary elimination is common in patients with CRF as the kidneys lose their ability to filter waste products through urine production. Through multiple realistic client scenarios, students are challenged to make important healthcare decisions that significantly impact client outcomes, without the need for clinical presence or risk to client safety. problem, what is it, SerpinaA3K(/) knockout (KOSA3) mice were acquired in The Jackson Laboratory under a genetic background C57BL/6NJ. Elsevier, Inc. We also showed that SerpinA3K is expressed in the renal tubular epithelium and that in AKI and AKI to CKD transition in the rat, as well as in patients with lupus nephritis, it is relocated from the cytosol to the tubular apical membrane, suggesting that it is secreted during renal damage. does he/she want? Zhong, X.; Tang, T.-T.; Shen, A.-R.; Cao, J.-Y. This can occur in any part of the GI tract, from the mouth to the anus. Accurate diagnosis of the underlying cause is key to successful management and includes a focused history and physical examination, serum and urine electrolyte measurements, and renal ultrasonography when risk factors for a postrenal cause are present (e.g., older male with prostatic hypertrophy). Based upon Nurse Chris' findings and the information contained within the EMR, which of the following actions should Nurse Chris take? As expected, I/R increased serum creatinine and BUN, with a GFR reduction in both genotypes; however, renal dysfunction was ameliorated in the KOSA3+IR group. Hukriede, N.A. The data distributions are represented as mean IC95%. No. ; writingreview and editing, I.G.-S., A.D.S.-V., M.A.M.-R., J.A.O.-T., R.P.-V., G.G., A.S.-N. and N.A.B. sodium bicarb, Lactulose promotes the fecal excretion of electrolytes as well as ammonia, urea, and creatinine. The role of Nrf2 in acute kidney injury: Novel molecular mechanisms and therapeutic approaches. Question: Using the SBAR format, identify the information Nurse Allyson received from report that will enable her to provide safe care to Mr. Jones. He smokes one pack of. Discuss a real-life example of the Thoma. View Administer fluids with caution.Fluid therapy can help with promoting urinary elimination but can cause worsening fluid retention and electrolyte imbalances. Course Outcome: Apply the nursing process using information technology and evidence- -Ability to attend dialysis sessions. Ati real life kidney disease. Repeated Episodes of Ischemia/Reperfusion Induce Heme-Oxygenase-1 (HO-1) and Anti-Inflammatory Responses and Protects against Chronic Kidney Disease. ; et al. ; supervision, N.A.B. es, diuretics, Acute kidney injury is a complex clinical syndrome with prerenal, intrinsic renal, and postrenal etiologies.10 Table 3 summarizes these etiologies.1013. No. permanent kidney 4. End of life practices in India. Zhang, B.; Zhou, K.K. My blood pressure may decrease during hemodialysis. Garca-Ortuo, L.E. ; Rosetti, F.; Bobadilla, N.A. https://www.mdcalc.com/fractional-excretion-sodium-fena, https://www.mdcalc.com/fractional-excretion-urea-feurea, https://www.mdcalc.com/mean-arterial-pressure-map, Consistent evidence from RCTs showing no clear renal or mortality benefit of colloids over isotonic crystalloids, Evidence from cohort studies and a limited number of RCTs showing improved mortality and decreased need for renal replacement therapy, Evidence from a limited number of cohort studies showing improvements in hospital mortality and acute kidney injury progression, Consistent evidence from multiple RCTs and meta-analysis, Hemorrhage, gastrointestinal losses, renal losses, skin and mucous membrane losses, nephrotic syndrome, cirrhosis, capillary leak, Sepsis, cirrhosis, anaphylaxis, pharmacologic adverse effects, Cardiogenic shock, pericardial diseases, congestive heart failure, valvular diseases, pulmonary diseases, sepsis, Early sepsis, hepatorenal syndrome, acute hypercalcemia, pharmacologic adverse effects, iodinated contrast media, Hematologic disorders: hemolytic uremic syndrome, thrombotic thrombocytopenic purpura, Inflammation: antiglomerular basement membrane disease, antineutrophil cytoplasmic antibody disease, infection, cryoglobulinemia, membranoproliferative glomerulonephritis, immunoglobulin A nephropathy, systemic lupus erythematosus, Henoch-Schnlein purpura, polyarteritis nodosa, Malignant hypertension, toxemia of pregnancy, hypercalcemia, radiocontrast media, scleroderma, pharmacologic adverse effects, Endogenous toxins: myoglobin, hemoglobin, paraproteinemia, uric acid, Exogenous toxins: antibiotics, chemotherapy agents, radiocontrast media, phosphate preparations, Vascular causes (e.g., large vessel diseases, such as renal artery thrombosis; embolism; stenosis; and operative renal arterial clamping), Arterial thrombosis, vasculitis, dissection, thromboembolism, venous thrombosis, compression, trauma, Bladder: neck obstruction, calculi, carcinoma, infection (schistosomiasis), Functional: neurogenic bladder, diabetes, multiple sclerosis, stroke, pharmacologic adverse effects (anticholinergics, antidepressants), Prostate: benign prostatic hypertrophy, carcinoma, infection, Urethral: posterior urethral valves, strictures, trauma, infections, tuberculosis, tumors, Retroperitoneal space tumors, pelvic or intra-abdominal tumors, retroperitoneal fibrosis, ureteral ligation or surgical trauma, granulomatous disease, hematoma, Nephrolithiasis, strictures, edema, debris, blood clots, sloughed papillae, fungal ball, malignancy, Acute or chronic tubulointerstitial injury, Leukocyturia, renal tubular epithelial cells, white blood cell casts, and granular casts, Drug-induced or endogenous crystalline nephropathy, Urinary acanthocytes and red blood cell casts, Renal tubular epithelial cells, renal tubular epithelial cell casts, and muddy brown casts, NSAIDs (ibuprofen, naproxen, ketorolac, celecoxib), ACEi (captopril, lisinopril, benazepril, ramipril), ARB (losartan, valsartan, candesartan, irbesartan), Analgesics (morphine, meperidine, gabapentin, pregabalin), Antivirals (acyclovir, ganciclovir, valganciclovir), Antimicrobials (almost all antimicrobials need dose adjustment in AKI, with important exceptions of azithromycin, ceftriaxone, doxycycline, linezolid, moxifloxacin, nafcillin, rifampin), Diabetic agents (sulfonylureas, metformin), Potassium level > 6.5 mEq per L (6.5 mmol per L), Urea nitrogen concentrations > 84 mg per dL (30 mmol per L), pH < 7.2 despite normal or low partial pressure of carbon dioxide in arterial blood, Pulmonary edema unresponsive to diuretics. Is there anything started, and how 3. All Rights Reserved. NurseTogether.com does not provide medical advice, diagnosis, or treatment. The molecular weight is around 4655 kD. The data that support the findings of this study are available on request from the corresponding author (NAB). A fractional excretion of urea less than 35% suggests a prerenal cause, whereas a value greater than 50% suggests an intrinsic cause. https://doi.org/10.3390/ijms24097815, Subscribe to receive issue release notifications and newsletters from MDPI journals, You can make submissions to other journals. `You have to be careful about pouring drano down your pipes since it is mainly hydrochloric acid--you can't do it if they are made of aluminum because it will dissolve them! 2018. Which of the following statements by Ms. Swisher should indicate to Nurse Chris that teaching was effective? Around shift change he was brought up to our floor. ; Prez-Villalva, R.; Uribe, N.; Bobadilla, N.A. Martnez-Rojas, M.; Snchez-Navarro, A.; Meja-Vilet, J.M. ; Goldstein, S.L. Chronic kidney disease - Symptoms and causes - Mayo Clinic ; Ortega-Trejo, J.A. Wei, W.; Ma, N.; Fan, X.; Yu, Q.; Ci, X. Which of the following sounds should Nurse Sam expect to hear? Provide care to edematous extremities as needed.Patients with CRF often exhibit lower extremity edema or anasarca due to excess fluid retention. Xu, Z.-H.; Wang, C.; He, Y.-X. Asthma can be broken down into two groups foundation up the causes of an attacked: extrinsic . Last set of Labs were Sodium 128, Potassium 5, BUN 44, Real Life 3.0 Scenario PN Medical Surgical: Kidney Disease Notes - Real We observed a remarkable change in the UH, It has been reported that the deacetylase Sirtuin-1 is a stress-responsive protein that protects against ROS in mice with AKI, attenuating the damage of renal cells. ; Mizisin, A.P. patient, room number. across the patient care experience. Sell. ; Hutchens, M.P. Sirt1 activation protects the mouse renal medulla from oxidative injury. Multiple requests from the same IP address are counted as one view. admission, List of current You may stop and replay as needed. Research. Acute kidney injury is defined as the sudden loss of kidney function over hours to days resulting in the inability to maintain electrolyte, acid-base, and water balance. Use a sterile technique to change the dressing. Which of the following rhythms should Nurse Chris expect based on Ms. Swisher's potassium level? Serum BUN and electrolyte concentration were automatically evaluated with a SYNCHRON System (Beckman Coulter, Brea, CA, USA). S- SituationThe ED admitted Mr. Jones at 4:30 AM for SOB and weakness. ; Edipidis, K.; Forni, L.G. ab49900) overnight at 4 C. Jones has not voided since he has been admitted. Influence of tissue perfusion on the outcome of high-risk surgical patients needing blood transfusion. We previously showed that SerpinA3K is present in urine from rats and humans with acute kidney injury (AKI) and chronic kidney disease (CKD). Real Life Clinical Reasoning Scenarios | ATI Nurse Sam has completed documentation of their assessment in the EMR. PDF Ati Real Life Scenario Answers Renal Experimental models of acute kidney injury for translational research. Which of the following illustrations should Nurse Chris use? Rayego-Mateos, S.; Marquez-Expsito, L.; Rodrigues-Diez, R.; Sanz, A.B. Please let us know what you think of our products and services. Providing accurate information about the disease process and encouraging the patient to adhere to lifestyle modifications are within the scope of the nurse. recommend Furosemide to start helping Mr. Jones void and See further details. Editors Choice articles are based on recommendations by the scientific editors of MDPI journals from around the world. Our website services and content are for informational purposes only. real life RN : kidney disease 3.0 aTi. Which of the following findings should Nurse Sam identify as an indication that Ms. Swisher could be experiencing disequilibrium syndrome? A. use a 3mL syringe for admin of IV meds. GFR is determined by the creatinine level and shows how well the kidneys are filtering. FOXO transcription factors: Their clinical significance and regulation. Report Tutorial Real ATI Real Life Kidney Disease Ati Real Life Scenario Answers Renal cetara de April 27th, 2018 - Download and Read Ati Real Life Scenario Answers Renal Ati Real Life Scenario Answers Renal In this age of modern era the use of internet must be maximized ns1.originalelement.co.uk 1 / 12 Acute tubular necrosis, the most common intrinsic kidney injury, is damage to the tubular cells of the kidney from ischemic or nephrotoxic causes. Actual results, performance or experience may differ materially from those expressed or implied by any forward-looking statement as a result of various risks, uncertainties and other factors, including, but not limited to, risks associated with: decisions made by health authorities, such as the FDA, with respect to regulatory filings; the potential therapeutic benefits, safety profile, and effectiveness of vadadustat; the direct or indirect impact of the COVID-19 pandemic on regulators and Akebia's business, operations, and the markets and communities in which Akebia and its partners, collaborators, vendors and customers operate; manufacturing, supply chain and quality matters and any recalls, write-downs, impairments or other related consequences or potential consequences; early termination of any of Akebia's collaborations; and the competitive landscape for vadadustat, if approved.

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