Sepsis and Acute Kidney Injury: A Review Focusing on the Bidirectional Interplay.
Sepsis and Acute Kidney Injury: A Review Focusing on the Bidirectional Interplay.
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DOI：
10.3390/ijms23169159
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发表时间：
2022-08-15
影响因子：
5.6
通讯作者：
中科院分区：
文献类型：
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作者：
虽然脓毒症和急性肾损伤（阿基）之间存在双向相互作用，但阿基和脓毒症之间的病理生理机制尚未阐明，值得进行全面和更新的综述。脓毒症相关阿基（SA-AKI）的主要病理生理学包括炎症级联反应、大血管和微血管功能障碍、细胞周期阻滞和细胞凋亡。阿基后败血症的病理生理学包括液体超负荷、高炎症状态、免疫抑制以及与肾脏替代治疗和导管插管相关的感染。SA-AKI的预防策略是非特异性的，主要集中在感染控制和防止进一步的肾损伤。另一方面，阿基后脓毒症的预防策略可能侧重于减少某些代谢产物、细胞因子或对我们的免疫有害的分子，补充维生素D3以发挥其免疫调节作用，并避免液体过载和不必要的导管插管。到目前为止，一些局限性持续阻碍双向病理生理学的理解。开展研究，如肾脏精准医学项目，以调查人类肾脏组织，并建立更好的参数或评分，以确定脓毒症和阿基的发生时间以及SA-AKI的定义，可能是揭开神秘面纱并改善阿基患者预后的前景。
Although sepsis and acute kidney injury (AKI) have a bidirectional interplay, the pathophysiological mechanisms between AKI and sepsis are not clarified and worthy of a comprehensive and updated review. The primary pathophysiology of sepsis-associated AKI (SA-AKI) includes inflammatory cascade, macrovascular and microvascular dysfunction, cell cycle arrest, and apoptosis. The pathophysiology of sepsis following AKI contains fluid overload, hyperinflammatory state, immunosuppression, and infection associated with kidney replacement therapy and catheter cannulation. The preventive strategies for SA-AKI are non-specific, mainly focusing on infection control and preventing further kidney insults. On the other hand, the preventive strategies for sepsis following AKI might focus on decreasing some metabolites, cytokines, or molecules harmful to our immunity, supplementing vitamin D3 for its immunomodulation effect, and avoiding fluid overload and unnecessary catheter cannulation. To date, several limitations persistently prohibit the understanding of the bidirectional pathophysiologies. Conducting studies, such as the Kidney Precision Medicine Project, to investigate human kidney tissue and establishing parameters or scores better to determine the occurrence timing of sepsis and AKI and the definition of SA-AKI might be the prospects to unveil the mystery and improve the prognoses of AKI patients.
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影响因子：
19.6
作者：
Awad, Alaa S.;Rouse, Michael;Huang, Liping;Vergis, Amy L.;Reutershan, Joerg;Cathro, Helen P.;Linden, Joel;Okusa, Mark D.
通讯作者：
Okusa, Mark D.
影响因子：
19.6
作者：
Doi, Kent;Ishizu, Tomoko;Noiri, Eisei
通讯作者：
Noiri, Eisei
影响因子：
13.6
作者：
Al-Jaghbeer, Mohammed;Dealmeida, Dilhari;Kellum, John A.
通讯作者：
Kellum, John A.
急性肾脏损伤和肠道营养不良：叙述性综述着重于病理生理学和治疗。
影响因子：
5.6
作者：
Chou YT;Kan WC;Shiao CC
通讯作者：
Shiao CC
DOI：
10.1186/s13054-015-0741-z
发表时间：
2015-01-28
期刊：
Critical care (London, England)
影响因子：
--
作者：
Chelazzi C;Villa G;Mancinelli P;De Gaudio AR;Adembri C
通讯作者：
Adembri C