Renal perfusion in sepsis: from macro- to microcirculation

Emiel Hendrik Post, John A. Kellum, Rinaldo Bellomo, Jean-Louis Vincent

Research output: Contribution to journalReview ArticleResearchpeer-review

63 Citations (Scopus)

Abstract

The pathogenesis of sepsis-associated acute kidney injury is complex and likely involves perfusion alterations, a dysregulated inflammatory response, and bioenergetic derangements. Although global renal hypoperfusion has been the main target of therapeutic interventions, its role in the development of renal dysfunction in sepsis is controversial. The implications of renal hypoperfusion during sepsis probably extend beyond a simple decrease in glomerular filtration pressure, and targeting microvascular perfusion deficits to maintain tubular epithelial integrity and function may be equally important. In this review, we provide an overview of macro- and microcirculatory dysfunction in experimental and clinical sepsis and discuss relationships with kidney oxygenation, metabolism, inflammation, and function.

Original languageEnglish
Pages (from-to)45-60
Number of pages16
JournalKidney International
Volume91
Issue number1
DOIs
Publication statusPublished - Jan 2017
Externally publishedYes

Keywords

  • acute kidney injury
  • renal hypoperfusion
  • sepsis

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