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Sepsis-Associated Acute Kidney Injury: Making Progress Against a Lethal Syndrome

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Critical Care Nephrology and Renal Replacement Therapy in Children

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Abstract

Sepsis and acute kidney injury (AKI) are disease processes that increase morbidity and mortality in hospitalized patients. Though separate entities, sepsis and AKI carry considerable pathophysiologic overlap and significantly worsen patient outcomes when concurrent. Sepsis is the most commonly associated condition with AKI in critically ill patients (S-AKI). Despite a multitude of epidemiologic data describing prevalence and associated outcomes, understanding of the complicated pathophysiology driving S-AKI is only superficial, appreciation of the disease phenotype is lacking, and current diagnostics are outdated. Ultimately, these shortcomings contribute to a large knowledge gap, resulting in a paucity of focused and effective therapeutic options. This chapter will detail available data, delineate the current paradigm and describe limitations, and then create a narrative describing a path necessary to follow in order to better manage S-AKI. Clinicians and researchers must move past the status quo, challenge assumptions, and simultaneously innovate, collaborate, and advocate for their patients suffering from this lethal condition.

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Authors and Affiliations

  1. Division of Pediatric Critical Care, Children’s Healthcare of Atlanta, Department of Pediatrics, Emory University, Atlanta, GA, USA

    Rajit K. Basu

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Correspondence to Rajit K. Basu .

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  1. Paediatric Intensive Care Unit, King’s College Hospital, London, United Kingdom

    Akash Deep

  2. Center for Acute Care Nephrology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA

    Stuart L. Goldstein

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Basu, R.K. (2018). Sepsis-Associated Acute Kidney Injury: Making Progress Against a Lethal Syndrome. In: Deep, A., Goldstein, S. (eds) Critical Care Nephrology and Renal Replacement Therapy in Children. Springer, Cham. https://doi.org/10.1007/978-3-319-90281-4_6

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  • DOI: https://doi.org/10.1007/978-3-319-90281-4_6

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