Acute kidney injury in sepsis: Is renal blood flow more than just an innocent bystander?
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Sir, The kidney is a common “victim organ” of various insults in critically ill patients, and, conversely, renal dysfunction adds substantially to the morbidity and mortality of these patients [1, 2]. Even relatively minor increments in serum creatinine levels coincide with markedly increased morbidity and mortality , highlighting the potentially important role of the kidney dysfunction during the natural history of critical illness. Sepsis and septic shock are the dominant cause of acute kidney injury (AKI), accounting for nearly 50% of episodes of acute renal failure . Nevertheless, the exact understanding of pathophysiologic mechanisms of sepsis-induced AKI that would allow the development of new therapeutic strategies to prevent AKI or to hasten its recovery still remains a mystery.
In this issue of “Intensive Care Medicine” Langenberg et al.  present a provocative, hypothesis-generating insight into the behavior of renal hemodynamics both during the injurious and the...
This work was supported by research grant MSM 0021620819 (Replacement of and support to some vital organs).
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