Renal perfusion in sepsis: from macro- to microcirculation

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• 作者：Emiel Hendrik Post¹ ; John A. Kellum² ; Rinaldo Bellomo³ ; Jean-Louis Vincent¹ ; ^{jlvincent@intensive.org}
• 关键词：acute kidney injury ; renal hypoperfusion ; sepsis
• 刊名：Kidney International
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：91
• 期：1
• 页码：45-60
• 全文大小：1287 K
• 卷排序：91

文摘

The pathogenesis of sepsis-associated acute kidney injury is complex and likely involves perfusion alterations, a dysregulated inflammatory response, and bioenergetic derangements. Although global renal hypoperfusion has been the main target of therapeutic interventions, its role in the development of renal dysfunction in sepsis is controversial. The implications of renal hypoperfusion during sepsis probably extend beyond a simple decrease in glomerular filtration pressure, and targeting microvascular perfusion deficits to maintain tubular epithelial integrity and function may be equally important. In this review, we provide an overview of macro- and microcirculatory dysfunction in experimental and clinical sepsis and discuss relationships with kidney oxygenation, metabolism, inflammation, and function.