Sepsis-Associated Acute Kidney Injury

Crit Care Clin. 2021 Apr;37(2):279-301. doi: 10.1016/j.ccc.2020.11.010. Epub 2021 Feb 13.

Abstract

Sepsis-associated acute kidney injury (S-AKI) is a common and life-threatening complication in hospitalized and critically ill patients. It is characterized by rapid deterioration of renal function associated with sepsis. The pathophysiology of S-AKI remains incompletely understood, so most therapies remain reactive and nonspecific. Possible pathogenic mechanisms to explain S-AKI include microcirculatory dysfunction, a dysregulated inflammatory response, and cellular metabolic reprogramming. In addition, several biomarkers have been developed in an attempt to improve diagnostic sensitivity and specificity of S-AKI. This article discusses the current understanding of S-AKI, recent advances in pathophysiology and biomarker development, and current preventive and therapeutic approaches.

Keywords: AKI; Biomarkers; Inflammation; Metabolic reprogramming; Microcirculation; Sepsis.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury* / etiology
  • Acute Kidney Injury* / therapy
  • Biomarkers
  • Humans
  • Microcirculation
  • Renal Circulation
  • Sepsis* / complications

Substances

  • Biomarkers