Renal blood flow and acute kidney injury in septic shock: an arduous conflict that smolders intrarenally?

Honore, Patrick M; Jacobs, Rita; De Waele, Elisabeth; Diltoer, Marc; Spapen, Herbert D · Kidney Int · 2016

Level V

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Abstract

Sepsis-induced acute kidney injury (SAKI) is traditionally viewed as a process driven by a reduced blood flow and prone to benefit from vasopressive support. In ovine hyperdynamic septic shock, Lankadeva et al. report a significant and flow-independent intrarenal perfusion and oxygenation "mismatch" jeopardizing the renal medulla that was aggravated by norepinephrine. Medullary and urinary oxygenation changed in parallel, suggesting that urinary oxygenation may act as a biomarker to predict SAKI.

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