Sepsis associated acute kidney injury

Abstract

Sepsis is defined as organ dysfunction resulting from the host’s deleterious response to infection. One of the most common organs affected is the kidneys, resulting in sepsis associated acute kidney injury (SA-AKI) that contributes to the morbidity and mortality of sepsis. A growing body of knowledge has illuminated the clinical risk factors, pathobiology, response to treatment, and elements of renal recovery that have advanced our ability to prevent, detect, and treat SA-AKI. Despite these advances, SA-AKI remains an important concern and clinical burden, and further study is needed to reduce the acute and chronic consequences. This review summarizes the relevant evidence, with a focus on the risk factors, early recognition and diagnosis, treatment, and long term consequences of SA-AKI. In addition to literature pertaining to SA-AKI specifically, pertinent sepsis and acute kidney injury literature relevant to SA-AKI was included.

Optimal management of acute kidney injury in critically ill patients with invasive fungal infections being treated with liposomal amphotericin B

“…2 AKI in these patients is very common and can be associated with both sepsis itself and complications arising from its treatment. 9 In this clinical setting, it can be difficult to quantify the contribution of individual components to a patient's AKI. A careful assessment of the potential risk of a medication in the setting of AKI is essential.…”

Major Adverse Kidney Events Are Associated with the Aquaporin 5 -1364A/C Promoter Polymorphism in Sepsis: A Prospective Validation Study

“…While recent research has enhanced our knowledge of the pathobiology of sepsis-associated AKI [25], the AKI morbidity and mortality in sepsis remains unacceptably high, and studies illuminating further risk factors are needed to allow for better stratification of preventive strategies [7]. In this study, we considered an altered AQP5 expression documented to be evoked by the common AQP5 -1364A/C promoter SNP as a promising risk factor for sepsis-associated AKI.…”

“…These findings confirm the important role of the AQP5 -1364A/C polymorphism as an independent prognostic factor in sepsis. Furthermore, we demonstrate a strong association between this AQP5 polymorphism and susceptibility for major adverse kidney events suggesting a promising characteristic in terms of precision medicine.Cells 2020, 9, 904 2 of 11 AKI and its sequelae still remain a challenge [7,8], and patients are stratified for distinct AKI phenotypes associated with either recovery or poor prognosis [1,8].However, although several clinical risk factors for the development of AKI have been identified, the pathogenesis and mechanisms of AKI itself remain poorly understood [9]. Genetic factors have been proposed to contribute to interindividual differences of susceptibility to and recovery from AKI relevantly [10].…”

“…Cells 2020, 9, 904 2 of 11 AKI and its sequelae still remain a challenge [7,8], and patients are stratified for distinct AKI phenotypes associated with either recovery or poor prognosis [1,8].…”

Protein kinase C‐delta inhibition is organ‐protective, enhances pathogen clearance, and improves survival in sepsis

“…Kidney damage and development of acute kidney injury (AKI) is a frequent complication in patients with sepsis and other critical illnesses. 5,37 Studies indicate that neutrophils play a critical role in the development of AKI. 38 While IT administration of the PKCδ inhibitor was lung protective, it is not clear whether this treatment would also protect other distal organs.…”