Endotoxemia-Induced Release of Pro-inflammatory Mediators Are Associated With Increased Glomerular Filtration Rate in Humans in vivo

Abstract

was observed for TNF-α (R 2 = 0.33, p = 0.0509) and IL-1RA (R 2 = 0.28, p = 0.08). None of the kidney injury markers or changes in blood pressure were associated with GFR iohexol. In multiple linear regression analysis, both peak IL-6 (p = 0.002) and IL-8 (p = 0.01) concentrations remained significantly correlated with GFR iohexol , without collinearity. Discussion: Concentrations of pro-inflammatory cytokines, but not blood pressure, are correlated with the endotoxemia-induced increase in GFR in healthy volunteers. These findings may indicate that inflammatory mediators orchestrate the augmented GFR observed in a subgroup of sepsis patients.

Late augmented renal clearance in patients with COVID-19 in the intensive care unit. A prospective observational study

“…The mechanisms leading to ARC are not yet fully elucidated. However, in the better-organized ARC in bacterial sepsis patients, in which pro-inflammatory cytokines and increased renal blood flow in the hyperdynamic early phase of sepsis may be the driving force [ 2 , [5] , [6] , [7] , [8] ]. The occurrence of ARC in the later phases of ICU admission in critically ill COVID-19 patients may imply that the ARC may be of different origin.…”

Pregnancy tailors endotoxin-induced monocyte and neutrophil responses in the maternal circulation

“…Tissue factor is necessary for thrombin formation in the coagulation cascade [ 66 ], and the increased frequency of intermediate monocytes expressing tissue factor in the current study is consistent with a previous report showing elevated tissue factor activity in women with preterm labor and intra-amniotic infection [ 67 ]. Similarly, increased expression of multiple immune mediators, including IL-6 and IL-1RA, has been found in response to experimental endotoxemia in human volunteers [ 68 ]. In the context of pregnancy, amniotic fluid IL-6 is a clinically established biomarker of intra-amniotic inflammation [ 69 ] and was predicted as one of the activated upstream regulators of cytokine signaling in monocytes from the amniotic cavity of women with this condition [ 36 ].…”

Augmented Renal Clearance in Severe Infections—An Important Consideration in Vancomycin Dosing: A Narrative Review

“…These factors may increase renal blood flow (RBF) and GFR ( Baptista et al, 2012 ; Udy et al, 2012 ). It has recently been suggested that an increase in GFR may also reflect a direct consequence of the inflammatory process, independent of haemodynamic changes in an experimental model of endotoxemia ( Beunders et al, 2020 ). Renal functional reserve (RFR) refers to the ability of the kidney to increase GFR in response to stress exposure.…”