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10.1097/MCC.0000000000000153

http://scihub22266oqcxt.onion/10.1097/MCC.0000000000000153
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C4495653!4495653!25320909
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suck abstract from ncbi


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pmid25320909      Curr+Opin+Crit+Care 2014 ; 20 (6): 588-95
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  • Sepsis-induced AKI revisited: pathophysiology, prevention and future therapies #MMPMID25320909
  • Zarbock A; Gomez H; Kellum JA
  • Curr Opin Crit Care 2014[Dec]; 20 (6): 588-95 PMID25320909show ga
  • Purpose of review: Acute kidney injury (AKI) is a common complication in critically ill patients and is associated with increased morbidity and mortality. Sepsis is the most common cause of AKI. Considerable evidence now suggests that the pathogenic mechanisms of sepsis-induced AKI are different from those seen in other etiologies of AKI. This review focuses on the recent advances in this area and discusses possible therapeutic interventions that might derive from these new insights into the pathogenesis of sepsis-induced AKI. Recent findings: The traditional paradigm that sepsis-induced AKI arises from ischemia has been challenged by recent evidence that total renal blood flow (RBF) in is not universally impaired during sepsis, and AKI can develop in the presence of normal or even increased RBF. Animal and human studies suggest that adaptive responses of tubular epithelial cells to injurious signals are responsible for renal dysfunction. Simultaneously occurring renal inflammation and microcirculatory dysfunction further amplify these mechanisms. Summary: An understanding of the pathologic mechanisms of sepsis-induced AKI emphasizes the important role of maladaptive responses to the septic insult. Preventive and therapeutic measures should be based on counteracting these maladaptive responses of tubular epithelial cells, inflammation, and microvascular dysfunction.
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