Lung injury following acute kidney injury: kidney-lung crosstalk
Lung injury following acute kidney injury: kidney-lung crosstalk
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DOI：
10.1007/s10157-011-0459-4
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发表时间：
2011-08-01
影响因子：
2.3
通讯作者：
Noiri, Eisei
中科院分区：
文献类型：
--
作者：
Doi, Kent;Ishizu, Tomoko;Noiri, Eisei
急性肾损伤（阿基）的死亡率仍然高得令人无法接受，特别是与急性呼吸衰竭相关。阿基合并肺损伤以前被认为是“尿毒症肺”，其特征是容量超负荷和血管通透性增加。最近出现了使用啮齿动物肾缺血再灌注模型和双侧肾切除术的新实验数据，重点关注阿基中的肾-肺串扰，并强调了细胞因子浓度增加、炎症反应增强和中性粒细胞活化的病理生理学意义。在这篇综述中，我们概述了尿毒症肺和急性肺损伤（ALI）/急性呼吸窘迫综合征（ARDS）的历史，阿基和肺损伤对死亡率的协同作用的流行病学数据，以及最近的基础研究已经确定了AKI诱导的肺损伤的可能途径。这些发现将使我们能够开发新的治疗策略，以对抗与阿基相关的肺损伤，并改善重症监护室中危重患者的预后。
The mortality of acute kidney injury (AKI) remains unacceptably high, especially associated with acute respiratory failure. Lung injury complicated with AKI was previously considered as "uremic lung", which is characterized by volume overload and increased vascular permeability. New experimental data using rodent models of renal ischemia-reperfusion and bilateral nephrectomy have emerged recently focusing on kidney-lung crosstalk in AKI, and have highlighted the pathophysiological significance of increased cytokine concentration, enhanced inflammatory responses, and neutrophil activation. In this review, we outline the history of uremic lung and acute lung injury (ALI)/acute respiratory distress syndrome (ARDS), the epidemiological data on the synergistic effect of AKI and lung injury on mortality, and recent basic research which has identified possible pathways in AKI-induced lung injury. These findings will enable us to develop new therapeutic strategies against lung injury associated with AKI and improve the outcomes of critically ill patients in intensive care units.