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Comprehensive Management of Blood Pressure in Patients with Septic AKI

Acute kidney injury (AKI) is one of the serious complications of sepsis in clinical practice, and is an important cause of prolonged hospitalization, death, increased medical costs, and a huge medical burden to society. The pathogenesis of AKI associated with sepsis is relatively complex and include...

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Autores principales: Deng, Junhui, Li, Lina, Feng, Yuanjun, Yang, Jurong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9917880/
https://www.ncbi.nlm.nih.gov/pubmed/36769666
http://dx.doi.org/10.3390/jcm12031018
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author Deng, Junhui
Li, Lina
Feng, Yuanjun
Yang, Jurong
author_facet Deng, Junhui
Li, Lina
Feng, Yuanjun
Yang, Jurong
author_sort Deng, Junhui
collection PubMed
description Acute kidney injury (AKI) is one of the serious complications of sepsis in clinical practice, and is an important cause of prolonged hospitalization, death, increased medical costs, and a huge medical burden to society. The pathogenesis of AKI associated with sepsis is relatively complex and includes hemodynamic abnormalities due to inflammatory response, oxidative stress, and shock, which subsequently cause a decrease in renal perfusion pressure and eventually lead to ischemia and hypoxia in renal tissue. Active clinical correction of hypotension can effectively improve renal microcirculatory disorders and promote the recovery of renal function. Furthermore, it has been found that in patients with a previous history of hypertension, small changes in blood pressure may be even more deleterious for kidney function. Therefore, the management of blood pressure in patients with sepsis-related AKI will directly affect the short-term and long-term renal function prognosis. This review summarizes the pathophysiological mechanisms of microcirculatory disorders affecting renal function, fluid management, vasopressor, the clinical blood pressure target, and kidney replacement therapy to provide a reference for the clinical management of sepsis-related AKI, thereby promoting the recovery of renal function for the purpose of improving patient prognosis.
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spelling pubmed-99178802023-02-11 Comprehensive Management of Blood Pressure in Patients with Septic AKI Deng, Junhui Li, Lina Feng, Yuanjun Yang, Jurong J Clin Med Review Acute kidney injury (AKI) is one of the serious complications of sepsis in clinical practice, and is an important cause of prolonged hospitalization, death, increased medical costs, and a huge medical burden to society. The pathogenesis of AKI associated with sepsis is relatively complex and includes hemodynamic abnormalities due to inflammatory response, oxidative stress, and shock, which subsequently cause a decrease in renal perfusion pressure and eventually lead to ischemia and hypoxia in renal tissue. Active clinical correction of hypotension can effectively improve renal microcirculatory disorders and promote the recovery of renal function. Furthermore, it has been found that in patients with a previous history of hypertension, small changes in blood pressure may be even more deleterious for kidney function. Therefore, the management of blood pressure in patients with sepsis-related AKI will directly affect the short-term and long-term renal function prognosis. This review summarizes the pathophysiological mechanisms of microcirculatory disorders affecting renal function, fluid management, vasopressor, the clinical blood pressure target, and kidney replacement therapy to provide a reference for the clinical management of sepsis-related AKI, thereby promoting the recovery of renal function for the purpose of improving patient prognosis. MDPI 2023-01-28 /pmc/articles/PMC9917880/ /pubmed/36769666 http://dx.doi.org/10.3390/jcm12031018 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Deng, Junhui
Li, Lina
Feng, Yuanjun
Yang, Jurong
Comprehensive Management of Blood Pressure in Patients with Septic AKI
title Comprehensive Management of Blood Pressure in Patients with Septic AKI
title_full Comprehensive Management of Blood Pressure in Patients with Septic AKI
title_fullStr Comprehensive Management of Blood Pressure in Patients with Septic AKI
title_full_unstemmed Comprehensive Management of Blood Pressure in Patients with Septic AKI
title_short Comprehensive Management of Blood Pressure in Patients with Septic AKI
title_sort comprehensive management of blood pressure in patients with septic aki
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9917880/
https://www.ncbi.nlm.nih.gov/pubmed/36769666
http://dx.doi.org/10.3390/jcm12031018
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