Sepsis-associated acute kidney injury
Acute kidney injury (AKI) is an epidemic problem. Sepsis has long been recognized as a foremost precipitant of AKI. Sepsis-associated AKI (SA-AKI) portends a high burden of morbidity and mortality in both children and adults with critical illness. Although our understanding of its pathophysiology is...
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| Published in: | Seminars in nephrology Vol. 35; no. 1; pp. 2 - 11 |
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| Main Authors: | , , , |
| Format: | Journal Article |
| Language: | English |
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United States
01.01.2015
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| ISSN: | 1558-4488 |
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| Abstract | Acute kidney injury (AKI) is an epidemic problem. Sepsis has long been recognized as a foremost precipitant of AKI. Sepsis-associated AKI (SA-AKI) portends a high burden of morbidity and mortality in both children and adults with critical illness. Although our understanding of its pathophysiology is incomplete, SA-AKI likely represents a distinct subset of AKI contributed to by a unique constellation of hemodynamic, inflammatory, and immune mechanisms. SA-AKI poses significant clinical challenges for clinicians. To date, no singular effective therapy has been developed to alter the natural history of SA-AKI. Rather, current strategies to alleviate poor outcomes focus on clinical risk identification, early detection of injury, modifying clinician behavior to avoid harm, early appropriate antimicrobial therapy, and surveillance among survivors for the longer-term sequelae of kidney damage. Recent evidence has confirmed that patients no longer die with AKI, but from AKI. To improve the care and outcomes for sufferers of SA-AKI, clinicians need a robust appreciation for its epidemiology and current best-evidence strategies for prevention and treatment. |
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| AbstractList | Acute kidney injury (AKI) is an epidemic problem. Sepsis has long been recognized as a foremost precipitant of AKI. Sepsis-associated AKI (SA-AKI) portends a high burden of morbidity and mortality in both children and adults with critical illness. Although our understanding of its pathophysiology is incomplete, SA-AKI likely represents a distinct subset of AKI contributed to by a unique constellation of hemodynamic, inflammatory, and immune mechanisms. SA-AKI poses significant clinical challenges for clinicians. To date, no singular effective therapy has been developed to alter the natural history of SA-AKI. Rather, current strategies to alleviate poor outcomes focus on clinical risk identification, early detection of injury, modifying clinician behavior to avoid harm, early appropriate antimicrobial therapy, and surveillance among survivors for the longer-term sequelae of kidney damage. Recent evidence has confirmed that patients no longer die with AKI, but from AKI. To improve the care and outcomes for sufferers of SA-AKI, clinicians need a robust appreciation for its epidemiology and current best-evidence strategies for prevention and treatment. |
| Author | Basu, Rajit K Bagshaw, Sean M Goldstein, Stuart L Alobaidi, Rashid |
| Author_xml | – sequence: 1 givenname: Rashid surname: Alobaidi fullname: Alobaidi, Rashid organization: Department of Pediatrics, Division of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada – sequence: 2 givenname: Rajit K surname: Basu fullname: Basu, Rajit K organization: Center for Acute Care Nephrology, Cincinnati Children's Hospital and Medical Center, Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio – sequence: 3 givenname: Stuart L surname: Goldstein fullname: Goldstein, Stuart L email: stuart.goldstein@cchmc.org organization: Center for Acute Care Nephrology, Cincinnati Children's Hospital and Medical Center, Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio. Electronic address: stuart.goldstein@cchmc.org – sequence: 4 givenname: Sean M surname: Bagshaw fullname: Bagshaw, Sean M organization: Division of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/25795495$$D View this record in MEDLINE/PubMed |
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| Keywords | acute kidney injury critical care nephrology outcomes sepsis |
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| Snippet | Acute kidney injury (AKI) is an epidemic problem. Sepsis has long been recognized as a foremost precipitant of AKI. Sepsis-associated AKI (SA-AKI) portends a... |
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| SubjectTerms | Acute Kidney Injury - etiology Acute Kidney Injury - immunology Acute Kidney Injury - metabolism Aged Child Humans Hypoxia - metabolism Inflammation Outcome Assessment (Health Care) Oxidative Stress Risk Assessment Sepsis - complications |
| Title | Sepsis-associated acute kidney injury |
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