The pathology and biology of uremic pneumonitis

Bleyl, U.; Sander, Erich; Schindler, T.

doi:10.1007/bf01724840

Cited by 24 publications

(17 citation statements)

References 21 publications

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“…71 Notably, other features of ALI were also found in these autopsy series, including hyaline membranes, leading to the conclusion by some investigators that AKI might be considered a specific cause of ALI. 74 Taken together, these clinical data support the notion that AKI causes inflammation, endothelial damage, non-cardiogenic pulmonary oedema, and features of ALI ( Figure 2). …”

Section: Respiratory Complications In Akisupporting

confidence: 51%

Mechanisms and mediators of lung injury after acute kidney injury

2015

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Acute kidney injury (AKI) is a common complication in hospitalized patients, associated with >50% mortality in those in intensive care who require renal replacement therapy. Data suggest that AKI is a systemic disease that adversely affects the immune system and organ function, and in this way contributes to the high mortality observed in affected patients. Data from patients and animal models indicate that AKI adversely affects the lungs. Respiratory complications are common in patients with AKI and include pulmonary oedema, respiratory failure requiring mechanical ventilation, prolonged duration of mechanical ventilation, and prolonged weaning from mechanical ventilation. The development of respiratory failure in patients with AKI greatly increases the risk of death. Data from animal models support the notion that cardiogenic pulmonary oedema (from volume overload) and non-cardiogenic pulmonary oedema (from endothelial injury due to inflammation and apoptosis) can occur in AKI. In this Review we discuss the clinical, epidemiologic, and animal data that provide insights into the mechanisms by which AKI can lead to lung injury and respiratory complications. Elucidation of the mechanisms of lung injury and respiratory complications after AKI is essential to develop effective therapies and reduce the high mortality associated with AKI and respiratory failure.

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Section: Respiratory Complications In Akisupporting

confidence: 51%

Mechanisms and mediators of lung injury after acute kidney injury

2015

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“…They found no volume overload and increased BAL fluid protein concentration, indicating that fluid overload is not necessary to cause pulmonary lesions in uremic patients. Bleyl et al [13] examined 66 autopsy cases and reported that hyaline membrane formation was found not just in chronic renal failure but in all AKI patients. Physicians now recognize that the pulmonary edema found in end-stage renal disease (ESRD) patients can be rapidly resolved by dialysis induction, while patients with acute respiratory failure complicated with AKI show markedly higher mortality even if treated by dialysis [14,15].…”

Section: Uremic Lung In Akimentioning

confidence: 97%

Lung injury following acute kidney injury: kidney–lung crosstalk

et al. 2011

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The mortality of acute kidney injury (AKI) remains unacceptably high, especially associated with acute respiratory failure. Lung injury complicated with AKI was previously considered as "uremic lung", which is characterized by volume overload and increased vascular permeability. New experimental data using rodent models of renal ischemia-reperfusion and bilateral nephrectomy have emerged recently focusing on kidney-lung crosstalk in AKI, and have highlighted the pathophysiological significance of increased cytokine concentration, enhanced inflammatory responses, and neutrophil activation. In this review, we outline the history of uremic lung and acute lung injury (ALI)/acute respiratory distress syndrome (ARDS), the epidemiological data on the synergistic effect of AKI and lung injury on mortality, and recent basic research which has identified possible pathways in AKI-induced lung injury. These findings will enable us to develop new therapeutic strategies against lung injury associated with AKI and improve the outcomes of critically ill patients in intensive care units.

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“…Thus, in some patients, normal pulmonary capillary pressures have been recorded in the presence of pulmonary edema [6,7]. In aggreement with these reports are pathologic findings of diffuse alveolo-capillary damage, interstitial and intraalveolar edema, widespread atelectases, alveolar haemorrhages and pulmonary hyaline membranes in uremic patients with pulmonary edema [8]. Electron microscopic observations in patients with uremic lung show epithelial damage, varying from edematous swelling of the epithelial cells to total disruption and desquamation of the epithelium [9].…”

Section: B Pulmonary Edemamentioning

confidence: 86%

“…Electron microscopic observations in patients with uremic lung show epithelial damage, varying from edematous swelling of the epithelial cells to total disruption and desquamation of the epithelium [9]. No correlation was found between serum urea and creatinine levels and pathologic findings of uremic pneumonitis [8].…”

Section: B Pulmonary Edemamentioning

confidence: 97%

Disorders of Respiration and Sleep-Disordered Breathing in Patients with Chronic Renal Failure

Μάρκου¹,

Αθανασίου²,

Hroni³

et al. 2006

CRMR

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Chronic renal failure may be associated with a wide spectrum of respiratory disorders, varying from relatively minor derangements in pulmonary function testing, to frank pulmonary edema. Although complications like uremic lung are becoming increasingly rare in these patients with timely initiation of dialysis, dialysis itself can also exert a transient deleterious influence on gas exchange. Moreover, patients with chronic renal failure often exhibit disorders of the chemical control of breathing that probably contribute to sleep-disordered breathing. Sleep -disordered breathing is a common problem in patients with chronic renal failure, with a reported prevalence possibly exceeding 70% for end-stage renal disease. Sleep disorders, have a serious impact in the quality of life in chronic renal failure, and are probably associated with increased morbidity and mortality. The role of polysomnography and of active intervention in sleep disorders in these patients needs to be further elucidated.

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The pathology and biology of uremic pneumonitis

Cited by 24 publications

References 21 publications

Mechanisms and mediators of lung injury after acute kidney injury

Mechanisms and mediators of lung injury after acute kidney injury

Lung injury following acute kidney injury: kidney–lung crosstalk

Disorders of Respiration and Sleep-Disordered Breathing in Patients with Chronic Renal Failure

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