Recent knowledge on the pathophysiology of septic acute kidney injury: A narrative review

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• 作者：Hoi-Ping Shum ; FHKCP ; FHKAM (Medicine)^a ; ^{shumhp@ha.org.hk" class="auth_mail" title="E-mail the corresponding author} ; Wing-Wa Yan ; FRCP ; FHKAM (Medicine)^a ; Tak Mao Chan ; MD ; FRCP ; FHKAM (Medicine)^b
• 关键词：Sepsis ; Acute kidney injury ; Pathophysiology
• 刊名：Journal of Critical Care
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：31
• 期：1
• 页码：82-89
• 全文大小：720 K

文摘

Sepsis is the commonest cause of acute kidney injury in critically ill patients. Its pathophysiology is complex and not well understood. Until recently, it was believed that kidney hypoperfusion is the major contributor of septic acute kidney injury. However, recent publications have improved our understanding on this topic. We now know that its mechanisms included the following: (1) renal macrocirculatory and microcirculatory disturbance, (2) surge of inflammatory markers and oxidative stress, (3) coagulation cascade activation, and (4) bioenergetics adaptive response with controlled cell-cycle arrest aiming to prevent cell death. Uncovering these complicated mechanisms may facilitate the development of more appropriate therapeutic measures in the future.