Pharmacological targets in the renal peritubular microenvironment: implications for therapy for sepsis-induced acute kidney injury.
Pharmacological targets in the renal peritubular microenvironment: implications for therapy for sepsis-induced acute kidney injury.
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DOI：
10.1016/j.pharmthera.2012.01.004
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发表时间：
2012-05
影响因子：
13.5
通讯作者：
MacMillan-Crow, Lee Ann
中科院分区：
文献类型：
--
作者：
Mayeux, Philip R.;MacMillan-Crow, Lee Ann
关键词：
One of the most frequent and serious complications to develop in septic patients is acute kidney injury (AKI), a disorder characterized by a rapid failure of the kidneys to adequately filter the blood, regulate ion and water balance, and generate urine. AKI greatly worsens the already poor prognosis of sepsis and increases cost of care. To date, therapies have been mostly supportive; consequently there has been little change in the mortality rates over the last decade. This is due, at least in part, to the delay in establishing clinical evidence of an infection and the associated presence of the systemic inflammatory response syndrome and thus, a delay in initiating therapy. A second reason is a lack of understanding regarding the mechanisms leading to renal injury, which has hindered the development of more targeted therapies. In this review, we summarize recent studies, which have examined the development of renal injury during sepsis and propose how changes in the peritubular capillary microenvironment lead to and then perpetuate microcirculatory failure and tubular epithelial cell injury. We also discuss a number of potential therapeutic targets in the renal peritubular microenvironment, which may prevent or lessen injury and/or promote recovery.
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