Biology of sepsis: Its relevance to pediatric nephrology

Neal B. Blatt, Sushant Srinivasan, Theresa Mottes, Maureen M. Shanley, Thomas P. Shanley*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

12 Scopus citations

Abstract

Because of its multi-organ involvement, the syndrome of sepsis provides clinical challenges to a wide variety of health care providers. While multi-organ dysfunction triggered by sepsis requires general supportive critical care provided by intensivists, the impact of sepsis on renal function and the ability of renal replacement therapies to modulate its biologic consequences provide a significant opportunity for pediatric nephrologists and related care providers to impact outcomes. In this review, we aim to highlight newer areas of understanding of the pathobiology of sepsis with special emphasis on those aspects of particular interest to pediatric nephrology. As such, we aim to: (1) review the definition of sepsis and discuss advances in our mechanistic understanding of sepsis; (2) review current hypotheses regarding sepsis-induced acute kidney injury (AKI) and describe its epidemiology based on evolving definitions of AKI; (3) review the impact of renal failure on the immune system, highlighting the sepsis risk in this cohort and strategies that might minimize this risk; (4) review how renal replacement therapeutic strategies may impact sepsis-induced AKI outcomes. By focusing the review on these specific areas, we have omitted other important areas of the biology of sepsis and additional interactions with renal function from this discussion; however, we have aimed to provide a comprehensive list of references that provide contemporary reviews of these additional areas.

Original languageEnglish (US)
Pages (from-to)2273-2287
Number of pages15
JournalPediatric Nephrology
Volume29
Issue number12
DOIs
StatePublished - Dec 2014

Keywords

  • Acute kidney injury
  • Host immune response
  • Intensive care
  • Multi-organ dysfunction
  • Sepsis
  • Systemic inflammatory response syndrome

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Nephrology

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