Sepsis-associated acute kidney injury—treatment standard

Author:

Zarbock Alexander1,Koyner Jay L2ORCID,Gomez Hernando3,Pickkers Peter4,Forni Lui56,Nadim Mitra K,Bell Samira,Joannidis Michael,Kashani Kianoush,Pannu Neesh,Meersch Melanie,Reis Thiago,Rimmelé Thomas,Bagshaw Sean M,Bellomo Rinaldo,Cantaluppi Vicenzo,Deep Akash,De Rosa Silvia,Fernandez-Perez Xose,Husain-Syed Faeq,Kane-Gill Sandra L,Kelly Yvelynne,Mehta Ravindra L,Murray Patrick T,Ostermann Marlies,Prowle John,Ricci Zaccaria,See Emily J,Schneider Antoine,Soranno Danielle E,Tolwani Ashita,Villa Gianluca,Ronco Claudio,

Affiliation:

1. Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital of Münster, Münster, Germany and Outcomes Research Consortium , Cleveland, OH , USA

2. Section of Nephrology, Department of Medicine, University of Chicago , Chicago, IL , USA

3. Program for Critical Care Nephrology, Department of Critical Care Medicine, University of Pittsburgh , Pittsburgh, PA , USA

4. Department Intensive Care Medicine, Radboud University Medical Centre , Nijmegen , The Netherlands

5. Department of Critical Care, Royal Surrey Hospital Foundation Trust , Guildford, UK

6. Faculty of Health Sciences, University of Surrey , Guildford, UK

Abstract

ABSTRACT Sepsis is a host's deleterious response to infection, which could lead to life-threatening organ dysfunction. Sepsis-associated acute kidney injury (SA-AKI) is the most frequent organ dysfunction and is associated with increased morbidity and mortality. Sepsis contributes to ≈50% of all AKI in critically ill adult patients. A growing body of evidence has unveiled key aspects of the clinical risk factors, pathobiology, response to treatment and elements of renal recovery that have advanced our ability to detect, prevent and treat SA-AKI. Despite these advancements, SA-AKI remains a critical clinical condition and a major health burden, and further studies are needed to diminish the short and long-term consequences of SA-AKI. We review the current treatment standards and discuss novel developments in the pathophysiology, diagnosis, outcome prediction and management of SA-AKI.

Funder

German Research Foundation

Publisher

Oxford University Press (OUP)

Subject

Transplantation,Nephrology

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