期刊
BEST PRACTICE & RESEARCH-CLINICAL ANAESTHESIOLOGY
卷 31, 期 3, 页码 315-329出版社
ELSEVIER
DOI: 10.1016/j.bpa.2017.10.002
关键词
acute kidney injury; microcirculation; hemodynamic coherence; renal tissue oxygenation; renal blood flow
资金
- Fresenius Kabi
- Baxter Healthcare
- BBraun
- AM Pharma
- French Society of Anesthesiology and Intensive Care Medicine (SFAR)
Acute kidney injury (AKI) remains one of the main causes of morbidity and mortality in the intensive care medicine today. Its pathophysiology and progress to chronic kidney disease is still under investigation. In addition, the lack of techniques to adequately monitor renal function and microcirculation at the bedside makes its therapeutic resolution challenging. In this article, we review-current concepts related to renal hemodynamics compromise as being the event underlying AKI. In doing so, we discuss the physiology of the renal circulation and the effects of alterations in systemic hemodynamics that lead to renal injury specifically in the context of reperfusion injury and sepsis. The ultimate key culprit of AKI leading to failure is the dysfunction of the renal microcirculation. The cellular and subcellular components of the renal microcirculation are discussed and how their injury contributes to AKI is described. (c) 2017 Published by Elsevier Ltd.
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