title: Recent knowledge on the pathophysiology of septic acute kidney injury: A narrative review.
abstract: Sepsis is the commonest cause of acute kidney injury in critically ill patients. Its pathophysiology is complex and not well understood. Until recently, it was believed that kidney hypoperfusion is the major contributor of septic acute kidney injury. However, recent publications have improved our understanding on this topic. We now know that its mechanisms included the following: (1) renal macrocirculatory and microcirculatory disturbance, (2) surge of inflammatory markers and oxidative stress, (3) coagulation cascade activation, and (4) bioenergetics adaptive response with controlled cell-cycle arrest aiming to prevent cell death. Uncovering these complicated mechanisms may facilitate the development of more appropriate therapeutic measures in the future.
authors.affiliation: Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong, China SAR. Electronic address: shumhp@ha.org.hk.
authors.forename: Hoi-Ping
authors.initials: HP
authors.lastname: Shum
authors.affiliation: Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong, China SAR.
authors.forename: Wing-Wa
authors.initials: WW
authors.lastname: Yan
authors.affiliation: Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong, China SAR.
authors.forename: Tak Mao
authors.initials: TM
authors.lastname: Chan
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy; D001777:Blood Coagulation / Q000502:physiology; D006801:Humans; D008833:Microcirculation / Q000502:physiology; D009569:Nitric Oxide / Q000378:metabolism; D018384:Oxidative Stress / Q000502:physiology; D012039:Regional Blood Flow / Q000502:physiology; D018805:Sepsis / Q000150:complications / Q000503:physiopathology*
chemical_list: D009569:Nitric Oxide
keywords: Acute kidney injury; Pathophysiology; Sepsis