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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Vydáno v:Seminars in nephrology Ročník 35; číslo 1; s. 2 - 11
Hlavní autoři: Alobaidi, Rashid, Basu, Rajit K, Goldstein, Stuart L, Bagshaw, Sean M
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States 01.01.2015
Témata:
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
acute kidney injury
critical care nephrology
outcomes
sepsis
ISSN:1558-4488
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Shrnutí: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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ISSN:1558-4488
DOI:10.1016/j.semnephrol.2015.01.002