title: [Lung and kidney failure. Pathogenesis, interactions, and therapy].
abstract: BACKGROUND
  The lungs and kidneys represent the most often affected organs (acute respiratory distress syndrome, ARDS or kidney failure) in multiple organ failure (MOF) due to shock, trauma, or sepsis with a still unacceptable high mortality for both organ failures.
  Although the exact pathophysiological mechanisms of MOF are not completely elucidated, it appears that the lungs and kidneys share several pathophysiologic pathways and have the potential to further harm each other (kidney-lung crosstalk). Inflammatory signals in both directions and volume overload with consecutive edema formation in both organs may play a key role in this crosstalk.
  
  
  METHODS
  The organ replacement therapies used in both organ failures have the potential to further injure the other organ (ventilator trauma, dialyte trauma). On the other hand, renal replacement therapy can have positive effects on lung injury by restoring volume and acid-base homeostasis. The new development of "low-flow" extracorporeal CO2 removal on renal replacement therapy platforms may further help to decrease ventilator trauma in the future.
authors: Medizinische Klinik 4, Universität Erlangen-Nürnberg, Erlangen, Deutschland. stefan.john@uk-erlangen.de.
authors: S
authors: S
authors: John
authors: Medizinische Klinik 4, Universität Erlangen-Nürnberg, Erlangen, Deutschland.
authors: C
authors: C
authors: Willam
mesh_terms: D003422:Critical Care; D015199:Extracorporeal Membrane Oxygenation; D005440:Fluid Therapy / Q000379:methods; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D008168:Lung / Q000503:physiopathology; D009102:Multiple Organ Failure / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D051437:Renal Insufficiency / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D017582:Renal Replacement Therapy; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D018805:Sepsis / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D016019:Survival Analysis
keywords: ARDS, human; Acute kidney injury; Extracorporeal CO2-elimination; Mechanical ventilation; Renal replacement therapy