Emerging therapeutic targets of sepsis-associated acute kidney injury.

Emerging therapeutic targets of sepsis-associated acute kidney injury.
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DOI:
10.1016/j.semnephrol.2015.01.005
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发表时间:
2015-01
影响因子:
3.3
通讯作者:
Okusa, Mark D.
Okusa, Mark D.
中科院分区:
医学2区
文献类型:
--
作者:
Swaminathan, Sundararaman;Rosner, Mitchell H.;Okusa, Mark D.

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脓毒症相关性急性肾损伤(SA-AKI)具有较高的发病率和死亡率。到目前为止,针对已知有助于SA-AKI发病的特定途径的单一方法都失败了。由于SA-AKI发病机制的复杂性,有必要重新评估SA-AKI的综合治疗方法,其中包括一般的支持性治疗,如血管升压剂、液体、抗菌药物的使用以及靶向和时间依赖的治疗。我们对SA-AKI的发病机制和治疗,包括促炎和抗炎过程的暂时性,有了最近的进展。在这篇综述中,我们将讨论新出现的治疗方法的临床和实验基础,这些治疗方法侧重于早期促炎和晚期抗炎过程,以及可能促进细胞存活和恢复的治疗方法。最后,我们包括正在进行的脓毒症临床试验。
Sepsis-associated acute kidney injury (SA-AKI) is linked to high morbidity and mortality. Thus far singular approaches to target specific pathways known to contribute to the pathogenesis of SA-AKI have failed. Because of the complexity of the pathogenesis of SA-AKI, a reassessment necessitates integrative approaches to therapeutics of SA-AKI that include general supportive therapies such as the use of vasopressors, fluids, antimicrobial and target specific and time dependent therapeutics. There has been recent progress in our understanding of the pathogenesis and treatment of SA-AKI including temporal nature of pro- and anti-inflammatory processes. In this review, we will discuss the clinical and experimental basis of emerging therapeutic approaches that focus on targeting early proinflammatory and late anti-inflammatory processes as well as therapeutics that may enhance cellular survival and recovery. Lastly we include ongoing clinical trials in sepsis.
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