Sepsis-associated acute kidney injury—treatment standard
Alexander Zarbock, Jay L. Koyner, Hernando Gómez, Peter Pickkers, Lui G. Forni, the Acute Disease Quality Initiative group, Mitra K. Nadim, Samira Bell, Michael Joannidis, Kianoush Kashani, Neesh Pannu, Melanie Meersch, Thiago Reis, Thomas Rimmelé, Sean M. Bagshaw, Rinaldo Bellomo, Vicenzo Cantaluppi, Akash Deep, Silvia De Rosa, Xose Fernandez-Perez, Faeq Husain‐Syed, Sandra L. Kane‐Gill, Yvelynne P. Kelly, Ravindra L. Mehta, Patrick Murray, Marlies Ostermann, John R. Prowle, Zaccaria Ricci, Emily See, Antoine Schneider, Danielle E. Soranno, Ashita Tolwani, Gianluca Villa, Claudio Ronco
Abstract
Sepsis is a host's deleterious response to infection, which could lead to life-threatening organ dysfunction. Sepsis-associated acute kidney injury (SA-AKI) is the most frequent organ dysfunction and is associated with increased morbidity and mortality. Sepsis contributes to ≈50% of all AKI in critically ill adult patients. A growing body of evidence has unveiled key aspects of the clinical risk factors, pathobiology, response to treatment and elements of renal recovery that have advanced our ability to detect, prevent and treat SA-AKI. Despite these advancements, SA-AKI remains a critical clinical condition and a major health burden, and further studies are needed to diminish the short and long-term consequences of SA-AKI. We review the current treatment standards and discuss novel developments in the pathophysiology, diagnosis, outcome prediction and management of SA-AKI.