PMID- 25845505
OWN - NLM
STAT- MEDLINE
DCOM- 20160418
LR  - 20220330
IS  - 1476-4431 (Electronic)
IS  - 1476-4431 (Linking)
VI  - 25
IP  - 2
DP  - 2015 Mar-Apr
TI  - Acute kidney injury in severe sepsis: pathophysiology, diagnosis, and treatment 
      recommendations.
PG  - 200-9
LID - 10.1111/vec.12297 [doi]
AB  - OBJECTIVE: To review the unique pathophysiology of sepsis-induced acute kidney 
      injury (AKI) and highlight the relevant aspects of the Kidney Disease: Improving 
      Global Outcomes (KDIGO) Clinical Practice Guideline for Acute Kidney Injury that 
      may apply to veterinary patients. DATA SOURCES: Electronic search of MEDLINE 
      database. HUMAN DATA SYNTHESIS: Sepsis-induced AKI is diagnosed in up to 47% of 
      human ICU patients and is seen as a major public health concern associated with 
      increased mortality and increased progression to chronic kidney disease (CKD). 
      Consensus criteria for the definition and classification of AKI has allowed for 
      accurate description of the epidemiology of patients with AKI. AKI develops from 
      a complex relationship between the initial insult and activation of inflammation 
      and coagulation. In contrast to the traditional view, clinical and experimental 
      data dispute the role of renal ischemia-reperfusion in the development of 
      sepsis-induced AKI. Renal tubular dysfunction with activation of the 
      tubuloglomerular feedback mechanism appears to be a crucial contributor to 
      sepsis-induced AKI. Furosemide and n-acetylcysteine (NAC) do not appear to be 
      helpful in the treatment of AKI. Hydroxyethyl starches (HES), dopamine, and 
      supraphysiological concentrations of chloride are harmful in patients with AKI. 
      VETERINARY DATA SYNTHESIS: Community and hospital-acquired AKI is a significant 
      factor affecting survival in critical ill patients. Sepsis-induced AKI occurs in 
      12% of dogs with abdominal sepsis and is an important contributor to mortality. 
      Early detection of AKI in hospitalized patients currently offers the best 
      opportunity to improve patient outcome. The use of urinary biomarkers to diagnose 
      early AKI should be evaluated in critical care patients. CONCLUSION: Veterinary 
      clinical trials comparing treatment choices with the development of AKI are 
      needed to make evidence-based recommendations for the prevention and treatment of 
      AKI.
CI  - (c) Veterinary Emergency and Critical Care Society 2015.
FAU - Keir, Iain
AU  - Keir I
AD  - Center for Critical Care Nephrology, The CRISMA (Clinical Research, 
      Investigation, and Systems Modeling of Acute Illness) Center, Department of 
      Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, 15260.
FAU - Kellum, John A
AU  - Kellum JA
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - J Vet Emerg Crit Care (San Antonio)
JT  - Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)
JID - 101152804
RN  - 0 (Biomarkers)
RN  - 0 (Hydroxyethyl Starch Derivatives)
SB  - IM
MH  - Acute Kidney Injury/complications/diagnosis/*veterinary
MH  - Animals
MH  - Biomarkers/blood/urine
MH  - Critical Care
MH  - Critical Illness
MH  - Dog Diseases/blood/*diagnosis/physiopathology/therapy/urine
MH  - Dogs
MH  - Humans
MH  - Hydroxyethyl Starch Derivatives/adverse effects
MH  - Practice Guidelines as Topic
MH  - Sepsis/complications/diagnosis/*veterinary
MH  - Veterinary Medicine
OTO - NOTNLM
OT  - acute kidney failure
OT  - kidney failure
OT  - organ dysfunction
EDAT- 2015/04/08 06:00
MHDA- 2016/04/19 06:00
CRDT- 2015/04/08 06:00
PHST- 2013/05/17 00:00 [received]
PHST- 2015/01/11 00:00 [accepted]
PHST- 2015/04/08 06:00 [entrez]
PHST- 2015/04/08 06:00 [pubmed]
PHST- 2016/04/19 06:00 [medline]
AID - 10.1111/vec.12297 [doi]
PST - ppublish
SO  - J Vet Emerg Crit Care (San Antonio). 2015 Mar-Apr;25(2):200-9. doi: 
      10.1111/vec.12297.