Mechanical Ventilation and Lung–Kidney Interactions

Koyner, Jay L.; Murray, Patrick

doi:10.2215/cjn.03090707

Cited by 73 publications

(58 citation statements)

References 84 publications

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“…PPV increases intrathoracic pressure, reducing venous return, cardiac output, and renal perfusion 146147148149. This proposed mechanical mechanism is supported by several landmark clinical trials of ARDS.…”

Section: Prevention and Medical Treatmentmentioning

confidence: 99%

Sepsis associated acute kidney injury

Poston

Koyner

2019

BMJ

482

381

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Sepsis is defined as organ dysfunction resulting from the host’s deleterious response to infection. One of the most common organs affected is the kidneys, resulting in sepsis associated acute kidney injury (SA-AKI) that contributes to the morbidity and mortality of sepsis. A growing body of knowledge has illuminated the clinical risk factors, pathobiology, response to treatment, and elements of renal recovery that have advanced our ability to prevent, detect, and treat SA-AKI. Despite these advances, SA-AKI remains an important concern and clinical burden, and further study is needed to reduce the acute and chronic consequences. This review summarizes the relevant evidence, with a focus on the risk factors, early recognition and diagnosis, treatment, and long term consequences of SA-AKI. In addition to literature pertaining to SA-AKI specifically, pertinent sepsis and acute kidney injury literature relevant to SA-AKI was included.

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Section: Prevention and Medical Treatmentmentioning

confidence: 99%

Sepsis associated acute kidney injury

Poston

Koyner

2019

BMJ

482

381

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“…Being on a ventilator during the study period could be another confounding factor. Positive pressure ventilation alters a variety of neurohumoral systems including sympathetic outflow, renin-angiotensin axis, antidiuretic hormone, and atrial natriuretic peptide release, all ultimately leading to a state of salt and water retention [9] . Medications, intravenous fluids and nasogastric feeds also alter the normal excretion of solutes.…”

Section: U Osm /U Cr In a Model Disease State And In Healthy Individualsmentioning

confidence: 99%

Spot Urine Osmolality/Creatinine Ratio in Healthy Humans

Godevithanage¹,

Kanankearachchi²,

Dissanayake³

et al. 2010

Kidney Blood Press Res

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Background: Spot urine albumin/creatinine ratio is a reliable estimate of 24-hour urine albumin excretion. In a pilot study, we observed that the spot urine osmolality/creatinine ratio (U_osm/U_cr) in healthy adults is reproducible. Therefore, we postulated that U_osm/U_cr of a spot urine sample may give an overall estimate of urinary excretion of solutes, renal concentrating ability and body hydration status. Method: Early morning spot urine samples were collected from healthy humans, frozen and analyzed in batches to establish spot U_osm/U_cr and its variation in relation to sex, age, body weight and height. Results: Two hundred and twenty-nine healthy volunteers participated. They were stratified into seven age groups: (a) 1.5–5, (b) >5–10, (c) >10–20, (d) >20–30, (e) >30–45, (f) >45–60, and (g) >60 years. Fifteen males and 15 females were allocated to each age category. A spot urine sample was collected from all subjects in the morning after the first void and was analyzed for osmolality and creatinine. The influence of age, sex, body weight and height on spot U_osm/U_cr was investigated using multiple linear regression. Only height showed a significant correlation (R² = 0.02). Further analysis after excluding the 1.5–5 years age group revealed no significant correlation between age, sex, body weight and height and the U_osm/U_cr ratio. Conclusion: Spot U_osm/ U_cr of healthy humans is a consistent index in steady state and needs no correction for sex, age and body weight above the age of 5 years.

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“…7). In patients with ALI, the mortality rate of those who develop acute kidney injury (defined as a 50% rise in creatinine) is 58% compared with 28% in those who do not develop acute kidney injury (8).…”

mentioning

confidence: 99%

Impact of acute kidney injury on lung injury

Liu¹

2009

American Journal of Physiology-Lung Cellular and Molecular Phys

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Mechanical Ventilation and Lung–Kidney Interactions

Cited by 73 publications

References 84 publications

Sepsis associated acute kidney injury

Sepsis associated acute kidney injury

Spot Urine Osmolality/Creatinine Ratio in Healthy Humans

Impact of acute kidney injury on lung injury

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