title: Recent advances in pathophysiology and biomarkers of sepsis-induced acute kidney injury.
abstract: Sepsis is a complex clinical syndrome characterized by a systemic inflammatory response to an infective insult. This process often leads to widespread tissue injury and multiple organ dysfunction. In particular, the development of acute kidney injury (AKI) is one of the most frequent complications, which increases the complexity and cost of care, and is an independent risk factor for mortality. Previous suggestions highlighting systemic hypotension, renal vasoconstriction and ischaemia-reperfusion injury as the primary pathophysiological mechanisms involved in sepsis-induced AKI have been challenged. Recently it has been shown that sepsis-induced AKI occurs in the setting of microvascular dysfunction with release of microparticles, inflammation and energetic adaptation of highly metabolic organs to cellular stress. The intolerable high mortality rate associated with sepsis-induced AKI is partially explained by an incomplete understanding of its pathophysiology and a delay in diagnosis. The aim of this review is to focus on advances in understanding the sepsis pathophysiology, with particular attention to the fundamental mechanisms of sepsis-induced AKI and the potential diagnostic and prognostic markers involved.
authors.affiliation: The Liver Unit, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, B15 2GW Birmingham, United Kingdom; Department of Clinical Medicine, Nephrology and Dialysis B, Sapienza University of Rome, Viale dell'Università 37, 00185 Rome, Italy. Electronic address: ilaria.umbro@hotmail.it.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Umbro
authors.affiliation: Department of Cellular Biotechnologies and Hematology, Sapienza University of Rome, Via Benevento 6, 00185 Rome, Italy. Electronic address: gentile@bce.uniroma1.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Gentile
authors.affiliation: The Liver Unit, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, B15 2GW Birmingham, United Kingdom; Department of Clinical Medicine, Nephrology and Dialysis B, Sapienza University of Rome, Viale dell'Università 37, 00185 Rome, Italy. Electronic address: francesca.tinti@uniroma1.it.
authors.forename: Francesca
authors.initials: F
authors.lastname: Tinti
authors.affiliation: The Liver Unit, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, B15 2GW Birmingham, United Kingdom. Electronic address: Paolo.Muiesan@uhb.nhs.uk.
authors.forename: Paolo
authors.initials: P
authors.lastname: Muiesan
authors.affiliation: Department of Clinical Medicine, Nephrology and Dialysis B, Sapienza University of Rome, Viale dell'Università 37, 00185 Rome, Italy. Electronic address: annapaola.mitter@uniroma1.it.
authors.forename: Anna Paola
authors.initials: AP
authors.lastname: Mitterhofer
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology* / Q000503:physiopathology*; D000818:Animals; D015415:Biomarkers / Q000032:analysis*; D004195:Disease Models, Animal; D006801:Humans; D018805:Sepsis / Q000150:complications* / Q000503:physiopathology*
chemical_list: D015415:Biomarkers
keywords: Acute kidney injury; Microparticles; Prognostic markers; Sepsis; Sepsis pathophysiology; Sepsis-induced acute kidney injury