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2014 ; 18
(3
): 225
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Brain-kidney crosstalk
#MMPMID25043644
Nongnuch A
; Panorchan K
; Davenport A
Crit Care
2014[Jun]; 18
(3
): 225
PMID25043644
show ga
Encephalopathy and altered higher mental functions are common clinical
complications of acute kidney injury. Although sepsis is a major triggering
factor, acute kidney injury predisposes to confusion by causing generalised
inflammation, leading to increased permeability of the blood-brain barrier,
exacerbated by hyperosmolarity and metabolic acidosis due to the retention of
products of nitrogen metabolism potentially resulting in increased brain water
content. Downregulation of cell membrane transporters predisposes to alterations
in neurotransmitter secretion and uptake, coupled with drug accumulation
increasing the risk of encephalopathy. On the other hand, acute brain injury can
induce a variety of changes in renal function ranging from altered function and
electrolyte imbalances to inflammatory changes in brain death kidney donors.