Acute Kidney Injury in Pediatric Sepsis

Mickells, Geoffrey E.; Moga, Michael Alice; Smith, Craig

doi:10.1016/j.cpem.2014.04.005

Cited by 5 publications

(3 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Severe sepsis and septic shock remain major causes of mortality and morbidity in intensive care units (ICUs) in developed countries, with sepsis long recognized as a precipitant of AKI. Adult patients with AKI in the context of sepsis have a mortality rate of 60%,1 while in children, this varies from 57% to 66% 2. Furthermore, the long-term outcome of an episode of AKI during a critical illness has recently been shown to be associated with significant morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

Update on sepsis-associated acute kidney injury: emerging targeted therapies

Doyle¹,

Forni²

2016

BTT

View full text Add to dashboard Cite

Sepsis-associated acute kidney injury (SA-AKI) is an independent predictor of increased mortality and morbidity. It is essential that further advances in the treatment of sepsis should prioritize targeted therapies in SA-AKI in order to improve these bleak outcomes. As yet, a unique therapy that effectively reduces the impact of acute kidney injury has not been demonstrated. However, the emergence of novel targeted therapies, perhaps in combination, has the possibility of significantly reducing the long-term sequelae of an episode of SA-AKI. In this review, we will focus on the shared etiology of these conditions and how this is managed with targeted therapy and finally the emerging novel therapies that may play an additional role to current treatment strategies.

show abstract

Section: Introductionmentioning

confidence: 99%

Update on sepsis-associated acute kidney injury: emerging targeted therapies

Doyle¹,

Forni²

2016

BTT

View full text Add to dashboard Cite

show abstract

“…The pathophysiology of septic AKI is related to the altered global renal blood flow, as well as the comprehensive effects of inflammation, microvasculature blood flow, and bioenergetics factors [7]. For example, glomerular endothelial injury during AKI progression in a lipopolysaccharide-induced mouse sepsis model is closely related to tumor necrosis factor and receptor 1 [8].…”

Section: Introductionmentioning

confidence: 99%

Baicalin Inhibits Renal Cell Apoptosis and Protects Against Acute Kidney Injury in Pediatric Sepsis

Zhu

2016

Med Sci Monit

View full text Add to dashboard Cite

BackgroundPediatric sepsis has high morbidity in children, may lead to acute kidney injury (AKI), and further aggravate the disease. Baicalin is a kind of flavonoid in Scutellaria baicalensis Georgi and has been reported to protect against several diseases, but its roles in septic AKI remain unclear. This study aimed to uncover the effects of baicalin in AKI during pediatric sepsis.Material/MethodsBlood urea nitrogen (BUN) and serum creatinine (Cr) levels were detected in 50 pediatric patients, who underwent basic therapy with or without baicalin adjunctive therapy. Mouse sepsis models were constructed by cecal ligation and puncture (CLP) and treated with baicalin intragastrically, after which BUN and Cr examination, TUNEL apoptosis assay, and expression analyses of BAX and BCL2 were performed.ResultsBaicalin adjunctive therapy significantly decreased BUN and Cr levels in pediatric sepsis patients (P<0.05). CLP led to elevated BUN and Cr levels in the mouse model (P<0.01), indicating kidney injury accompanied by sepsis. Baicalin decreased BUN and Cr levels (P<0.05), and reduced the apoptotic cell percent in the renal tissue (P<0.05) of the CLP model. It inhibited BAX and promoted BCL2 in the renal tissue, which was consistent with cell apoptosis changes.ConclusionsBaicalin is capable of suppressing renal cell apoptosis and protecting against AKI in pediatric sepsis. This study provides a potential adjunctive therapy for treating AKI in pediatric sepsis, and further research is necessary to reveal its deeper mechanisms.

show abstract

“…Furthermore, the death rate for adults with AKI during sepsis is 60% [ 19 ], and the figure for children ranges from 57% to 66% [ 20 ]. Sepsis-related AKI is more severe than nonseptic AKI and is linked with a higher fatality rate.…”

Section: Clinical and Preclinical Events Of Septic Acute Kidney Injurymentioning

confidence: 99%

Phosphodiesterase-4 Inhibitor Roflumilast-Mediated Protective Effect in Sepsis-Induced Late-Phase Event of Acute Kidney Injury: A Narrative Review

et al. 2022

View full text Add to dashboard Cite

Severe infections such as viral, bacterial, or fungal sepsis can cause an inflammatory response in the host, leading to organ failure and septic shock—phosphodiesterase-4 (PDE-4) inhibiting related agents from suppressing cyclic adenosine monophosphate (cAMP) degradation. Regulatory organisations have approved some substances in this category to reduce the risk of chronic obstructive pulmonary disease (COPD) exacerbations in patients with chronic bronchitis and a history of COPD exacerbations. Roflumilast has been shown to alleviate inflammatory responses, thus regulating airway inflammation. Additionally, roflumilast therapy dramatically enhanced B-cell lymphoma 2 (Bcl-2) expression, an anti-apoptotic marker lowered in septic animals. Previous research has indicated that roflumilast may help reverse sepsis-induced liver and lung harm, but whether it is also effective in reversing sepsis-induced renal impairment remains unknown. Therefore, this review determines whether roflumilast protects against renal dysfunction, inflammatory response, and apoptosis in sepsis-induced kidney damage. Additionally, we discussed the molecular mechanism through which roflumilast exerts its protective effect to uncover a possible treatment agent for sepsis-induced renal impairment.

show abstract

Acute Kidney Injury in Pediatric Sepsis

Cited by 5 publications

References 49 publications

Update on sepsis-associated acute kidney injury: emerging targeted therapies

Update on sepsis-associated acute kidney injury: emerging targeted therapies

Baicalin Inhibits Renal Cell Apoptosis and Protects Against Acute Kidney Injury in Pediatric Sepsis

Phosphodiesterase-4 Inhibitor Roflumilast-Mediated Protective Effect in Sepsis-Induced Late-Phase Event of Acute Kidney Injury: A Narrative Review

Contact Info

Product

Resources

About