Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2015 Jan;35(1):64-74.
doi: 10.1016/j.semnephrol.2015.01.007.

Sepsis-associated acute kidney injury: macrohemodynamic and microhemodynamic alterations in the renal circulation

John R Prowle  1 , Rinaldo Bellomo  2
Affiliations
Review

Sepsis-associated acute kidney injury: macrohemodynamic and microhemodynamic alterations in the renal circulation

John R Prowle et al. Semin Nephrol. 2015 Jan.

Abstract

Traditionally, renal ischemia has been regarded as central to the pathogenesis of sepsis-associated acute kidney injury (SA-AKI). Accordingly, hemodynamic management of SA-AKI has emphasized restoration of renal perfusion, whereas, experimentally, ischemia reperfusion models have been emphasized. However, in human beings, SA-AKI usually is accompanied by hyperdynamic circulation. Moreover, clinical and experimental evidence now suggests the importance of inflammatory mechanisms in the development of AKI and microcirculatory dysfunction more than systemic alteration in renal perfusion. In this review, we examine systemic, regional, and microcirculatory hemodynamics in SA-AKI, and attempt to rationalize the hemodynamic management of this condition.

Keywords: Acute kidney injury; critical care; hemodynamic management; microcirculation; renal blood flow; sepsis.

PubMed Disclaimer