Determinantes precoces en el desarrollo de injuria renal aguda durante la sepsis abdominal experimental
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Fecha
2014
Profesor/a Guía
Facultad/escuela
Idioma
es
Título de la revista
ISSN de la revista
Título del volumen
Editor
Sociedad Médica de Santiago
Nombre de Curso
Licencia CC
Licencia CC
Resumen
Background: Sepsis-induced acute kidney injury (AKI) is an early and
frequent organ dysfunction, associated with increased mortality. Aim: To evaluate
the impact of macrohemodynamic and microcirculatory changes on renal
function and histology during an experimental model of intra-abdominal sepsis.
Material and Methods: In 18 anaesthetized pigs, catheters were installed to
measure hemodynamic parameters in the carotid, right renal and pulmonary
arteries. After baseline assessment and stabilization, animals were randomly
divided to receive and intra-abdominal infusion of autologous feces or saline.
Animals were observed for 18 hours thereafter. Results: In all septic animals,
serum lactate levels increased, but only eight developed AKI (66%). These
animals had higher creatinine and interleukin-6 levels, lower inulin and paraaminohippurate
clearance (decreased glomerular filtration and renal plasma
flow), and a negative lactate uptake. Septic animals with AKI had lower values
of mean end arterial pressure, renal blood flow and kidney perfusion pressure,
with an associated increase in kidney oxygen extraction. No tubular necrosis
was observed in kidney histology. Conclusions: The reduction in renal blood
flow and renal perfusion pressure were the main mechanisms associated with
AKI, but were not associated with necrosis. Probably other mechanisms, such
as microcirculatory vasoconstriction and inflammation also contributes to AKI
development.
(Rev Med Chile 2014; 142: 551-558)
Key words: Acute kidney injury; Renal circulation; Sepsis.
Notas
Indexación: Web of Science; Scielo.
Palabras clave
Acute kidney injury; Renal circulation; Sepsis.
Citación
Rev. méd. Chile vol.142 no.5 Santiago mayo 2014