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Renal alterations in the septic patient

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Critical Care Nephrology

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Abstract

Considering the fact that sepsis, in varying guises, accounts wholly or in part, for more than 50% of cases of acute renal failure 11, 2], surprisingly little is known about the pathogenesis of this type of renal dysfunction. Many different experimental models have been studied in an attempt to understand the mechanisms involved. However, some of these experimental manoeuvres are of doubtful relevance to clinical practice, and do not reproduce the typical features of sepsis in patients. For example, although it seems clear that bacterial endotoxin, by activating a cascade of mediator systems, is focal to development of clinical sepsis, infusion of endotoxin alone into the isolated perfused kidney has no consistent effect on renal function or structure [3, 4]. This emphasises the extent to which secondary events, triggered by sepsis, are critical to the development of organ dysfunction. Understanding these mechanisms is crucial to the effective diagnosis and treatment of this type of acute renal failure [5, 6]. Many of the observations made in experimental models have still to be tested in clinical studies, and this remains a challenging area in terms of current management and future research.

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  1. Jane Goddard
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Goddard, J., Cumming, A.D. (1998). Renal alterations in the septic patient. In: Critical Care Nephrology. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-5482-6_42

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