Sepsis-Associated Acute Kidney Injury: Where Are We Now?

Medicina, Journal Year: 2024, Volume and Issue: 60(3), P. 434 - 434

Published: March 6, 2024

Worldwide, sepsis is a well-recognized cause of death. Acute kidney injury (AKI) may be related to in up 70% AKI cases. Sepsis-associated (SA-AKI) defined as the presence according Kidney Disease: Improving Global Outcomes criteria context sepsis. SA-AKI categorized into early, which presents during first 48 h sepsis, and late, presenting between 7 days associated with worse prognosis among patients However, there are different phenotypes well pathophysiological pathways SA-AKI. The aim this review provide an updated synopsis pathogenetic mechanisms underlying development analyze its prognosis. In addition, potential novel diagnostic prognostic biomarkers therapeutic approaches discussed. A plethora implicated pathogenesis SA-AKI, including inflammation metabolic reprogramming sepsis; various types cell death such apoptosis, necroptosis, pyroptosis ferroptosis; autophagy efferocytosis; hemodynamic changes (macrovascular microvascular dysfunction). Apart from urine output serum creatinine levels, have been incorporated definition AKI, several urinary also developed, comprising, others, interleukins 6, 8 18, osteoprotegerin, galectin-3, presepsin, cystatin C, NGAL, proenkephalin A, CCL-14, TIMP-2 L-FABP stemming multi-omics technologies machine learning algorithms. Interestingly, long non-coding RNAs (lncRNAs) microRNAs (miRNAs), PlncRNA-1, miR-22-3p, miR-526b, LncRNA NKILA, miR-140-5p miR-214, serve targets. combination omics represents innovative holistic approach toward providing more integrated view molecular physiological events for deciphering unique specific phenotypes. Although evidence still necessary, it expected that incorporation integrative useful not only early diagnosis risk but targets could revolutionize management personalized manner.

Language: Английский

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The role of phospholipid transfer protein in sepsis-associated acute kidney injury

Critical Care, Journal Year: 2025, Volume and Issue: 29(1)

Published: Jan. 20, 2025

Language: Английский

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Predicting a strongly positive fluid balance in critically ill patients with acute kidney injury: A multicentre, international study

Journal of Critical Care, Journal Year: 2025, Volume and Issue: 87, P. 155016 - 155016

Published: Jan. 23, 2025

Language: Английский

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Persistent severe acute kidney injury is a major modifiable determinant of outcome during critical illness

Intensive Care Medicine, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 18, 2025

Language: Английский

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Understanding, assessing and treating immune, endothelial and haemostasis dysfunctions in bacterial sepsis

Intensive Care Medicine, Journal Year: 2024, Volume and Issue: 50(10), P. 1580 - 1592

Published: Sept. 2, 2024

Language: Английский

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Extracorporeal Blood Purification and Acute Kidney Injury in Cardiac Surgery

JAMA, Journal Year: 2024, Volume and Issue: 332(17), P. 1446 - 1446

Published: Oct. 9, 2024

Importance Cardiac surgery – associated acute kidney injury (CSA-AKI) remains a significant problem following cardiopulmonary bypass (CPB). Various strategies are proposed to attenuate CSA-AKI, including extracorporeal blood purification (EBP), but little is known about the effect of EBP through an acrylonitrile-sodium methallylsulfonate/polyethyleneimine membrane during CPB. Objective To determine whether use device in nonemergent cardiac population reduces CSA-AKI after Design, Setting, and Participants This double-blind, randomized clinical trial was conducted 2 tertiary hospitals Spain. Patients 18 years or older undergoing who were at high risk for enrolled from June 15, 2016, November 5, 2021, with follow-up data February 2022. Of 1156 patients assessed, 343 (1:1) either receive standard care. Intervention Nonselective connected CPB circuit. Main Outcomes Measures The primary outcome rate 7 days randomization. Results Among (169 174 usual care), mean (SD) age 69 (9) 119 females. 28.4% (95% CI, 21.7%-35.8%) group vs 39.7% 32.3%-47.3%) care ( P = .03), adjusted difference 10.4% 2.3%-18.5%) using log-binomial model .01). No differences > .05) observed most predefined secondary end points post hoc exploratory points. In sensitivity analysis, found be more effective terms reduction chronic disease, diabetes, hypertension, low left ventricular ejection fraction (<40%), lower body mass index (<30). between groups adverse events tracking. Conclusions Relevance nonselective circuit first surgery. Trial Registration ClinicalTrials.gov Identifier: NCT02518087

Language: Английский

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The role of thromboinflammation in acute kidney injury among patients with septic coagulopathy

Journal of Thrombosis and Haemostasis, Journal Year: 2024, Volume and Issue: 22(6), P. 1530 - 1540

Published: Feb. 19, 2024

Language: Английский

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Sepsis-associated endothelial glycocalyx damage: a review of animal models, clinical evidence, and molecular mechanisms

International Journal of Biological Macromolecules, Journal Year: 2025, Volume and Issue: 295, P. 139548 - 139548

Published: Jan. 8, 2025

Language: Английский

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Impact of Nafamostat Mesylate Combined with Continuous Renal Replacement Therapy on Clinical Outcomes, Immune Function, and Oxidative Stress Markers in Patients with Sepsis-Associated Acute Kidney Injury

British Journal of Hospital Medicine, Journal Year: 2025, Volume and Issue: 86(2), P. 1 - 13

Published: Feb. 25, 2025

Aims/Background Sepsis is a prevalent critical condition associated with acute kidney injury (AKI). Nafamostat mesylate (NM), serine protease inhibitor, has anticoagulant and anti-inflammatory properties. This study aimed to investigate the effects of NM combined continuous renal replacement therapy (CRRT) on clinical efficacy, immune function, oxidative stress markers in patients sepsis-associated (SA-AKI). Methods A total 98 diagnosed SA-AKI treated at The People’s Hospital Pingyang between January 2022 2024 were included. Patients divided into two groups based their treatment regimen: CRRT group (n = 48) NM+CRRT 50). Clinical outcomes, including length stay intensive care unit (ICU) Acute Physiology Chronic Health Evaluation II (APACHE II) scores, analyzed. Changes assessed before after treatment. Adverse reactions also compared groups. Results effective rate was significantly higher than (p < 0.05). had shorter ICU stays lower APACHE scores those Baseline levels function markers, serum creatinine (SCr), blood urea nitrogen (BUN) similar > SCr BUN improved post-treatment, significant reductions observed Immune immunoglobulin G (IgG), (IgA) showed no differences baseline 0.05), but Oxidative glutathione peroxidase (GSH-Px), malondialdehyde (MDA) After treatment, MDA decreased, GSH-Px groups, more improvements group. incidence adverse 26.00% 16.67% group, statistically difference Conclusion enhances reduces stress. demonstrates an acceptable safety profile suitable for application.

Language: Английский

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Early Sepsis-Associated Acute Kidney Injury and Obesity

JAMA Network Open, Journal Year: 2024, Volume and Issue: 7(2), P. e2354923 - e2354923

Published: Feb. 6, 2024

The prevalence of obesity is increasing in the intensive care unit (ICU). Although a known risk factor for chronic kidney disease, its association with early sepsis-associated acute injury (SA-AKI) and their combined patient outcomes warrant further investigation.

Language: Английский

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