Sepsis-associated acute kidney injury: mechanisms and continuous renal replacement therapy / 中国小儿急救医学

ABSTRACT

Sepsis is frequently complicated by multiple organ dysfunctional syndrome, and particularly by acute kidney injury.Sepsis-associated acute kidney injury(SAKI)is associated with high risk of hospital mortality and worse disability.The pathophysiological mechanisms for SAKI are still not fully defined.More importance is now increasingly attributed to immunologic and inflammatory mechanisms, along with the activation of the coagulation cascade, triggering adaptive responses of apoptotic cell death and sublethal injury of tubular epithelial cells (TECs)that amplify and potentiate microvascular and endothelial damage.Continuous renal replacement therapy(CRRT)can remove toxins and inflammatory factors, maintain hemodynamics, moderate fluid imbalance.The mode include continuous veno-venous hemofiltration, high volume hemofiltration, continuous veno-venous hemodiafiltration, and etc.But the CRRT timing and dosage need further inquiry.