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      Comprehensive Management of Blood Pressure in Patients with Septic AKI.

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          Abstract

          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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          Author and article information

          Journal
          J Clin Med
          Journal of clinical medicine
          MDPI AG
          2077-0383
          2077-0383
          Jan 28 2023
          : 12
          : 3
          Affiliations
          [1 ] Department of Nephrology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing 400120, China.
          [2 ] Department of Renal Rheumatology, Space Hospital Affiliated to Zunyi Medical University, Zunyi 563002, China.
          Article
          jcm12031018
          10.3390/jcm12031018
          9917880
          36769666
          69bb782e-dd3f-4900-b537-8e9a88f036f5
          History

          acute kidney injury,blood pressure,microcirculation,prognosis,sepsis

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