Management of acute renal dysfunction in sepsis

Federico Nalesso, Zaccaria Ricci, Claudio Ronco

Research output: Contribution to journalArticlepeer-review

Abstract

Acute kidney injury (AKI) often complicates sepsis, leading to greater complexity and a worsening prognosis. Advances in the clinical management of sepsis may have secondary benefits with respect to renal outcomes. In critically ill patients, this disorder typically produces multiple organ dysfunction. Among the several disorders encountered in sepsis, AKI is one of the most important because it is a life-threatening condition, increases the complexity and cost of care, and is an independent risk factor for mortality. The potential interventions in sepsis-related AKI consist of effective prevention/protection strategies for the kidney in patients at risk, early recognition and attenuation of renal damage, pathophysiology-driven pharmacologic support, efficient extracorporeal blood purification therapy, and strategies that promote recovery of renal function. Existing and hybrid extracorporeal therapies are being investigated not only as means to replace lost kidney function, but also to modulate the immune response to sepsis.

Original languageEnglish
Pages (from-to)462-473
Number of pages12
JournalCurrent Infectious Disease Reports
Volume14
Issue number5
DOIs
Publication statusPublished - Oct 2012

Keywords

  • Acute kidney injury (AKI)
  • Acute lung injury (ALI)
  • Acute respiratory distress syndrome (ARDS)
  • Compensated anti-inflammatory response syndrome (CARS)
  • Continuous renal replacement therapy (CRRT)
  • Coupled plasma filtration adsorption (CPFA)
  • CVVH
  • Early goal-directed therapy (EGDT)
  • HFD
  • High cutoff membranes
  • High-volume hemofiltration (HVHF)
  • Multiple organ dysfunction syndrome (MODS)
  • Peak concentration hypothesis
  • Renal replacement therapy (RRT)
  • Sepsis
  • Sepsis-related acute kidney injury
  • Systemic inflammatory response syndrome (SIRS)

ASJC Scopus subject areas

  • Infectious Diseases

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