Volatile Anesthetics and AKI

Fukazawa, Kyota; Lee, H. Thomas

doi:10.1681/asn.2013111215

Cited by 73 publications

(65 citation statements)

References 92 publications

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“…[5][6][7] Ischemiareperfusion injury (IRI) is a common cause of AKI in clinical settings such as major cardiac surgery, hypovolemic shock, and renal transplantation. [8][9][10][11] The pathogenesis of IRI involves crosstalk between the kidney parenchyma and the immune system, with effects on renal hemodynamics and tubular injury. 12,13 Heme oxygenase-1 (HO-1) is an important cytoprotective enzyme that regulates the inflammatory response to tissue injury.…”

mentioning

confidence: 99%

Heme Oxygenase-1 Regulates Myeloid Cell Trafficking in AKI

Hull

Kamal²,

Boddu³

et al. 2015

Journal of the American Society of Nephrology

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Renal ischemia-reperfusion injury is mediated by a complex cascade of events, including the immune response, that occur secondary to injury to renal epithelial cells. We tested the hypothesis that heme oxygenase-1 (HO-1) expression, which is protective in ischemia-reperfusion injury, regulates trafficking of myeloid-derived immune cells in the kidney. Age-matched male wild-type (HO-1 +/+ ), HO-1-knockout donor kidneys, to the peripheral lymphoid organs. This effect on renal DC migration was corroborated in myeloid-specific HO-1 2/2 mice subjected to bilateral ischemia. These mice also displayed impaired renal recovery and increased fibrosis at day 7 after injury. These results highlight an important role for HO-1 in orchestrating the trafficking of myeloid cells in AKI, which may represent a key pathway for therapeutic intervention.

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mentioning

confidence: 99%

Heme Oxygenase-1 Regulates Myeloid Cell Trafficking in AKI

Hull

Kamal²,

Boddu³

et al. 2015

Journal of the American Society of Nephrology

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“…It has been proven that they activate multiple pathways to synthesize key cytoprotective and anti-infl ammatory signaling molecules to attenuate ischemic AKI, as has been detailed by Fukazawa and Lee 18 . In ischemia/reperfusion kidney injury, proinfl ammatory cytokines are produced in dying or injured cells of proximal tubules, while the increasing number of chemokines attracting cytotoxic neutrophils and cytotoxic T lymphocytes additionally contributes to the local infl ammatory response.…”

Section: Modulation Of Ischemia/reperfusion Injury and Anti-infl Ammamentioning

confidence: 96%

Effect of Inhalational Anesthetics on Acute Kidney Injury

Bublić

Tonković

Sakan³

et al. 2016

acc

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SUMMARY -Acute kidney injury (AKI) is a serious complication associated with increased morbidity and mortality. Total incidence of AKI in hospitalized patients is 1%-5%. As many as 30% of these patients develop AKI in the perioperative period, which is associated with anesthesia and surgery. Despite scientifi c advances and improved surgery techniques, as well as treatment in intensive care units, no signifi cant decrease in AKI incidence has been achieved. To change this outcome, it is important to identify patients at risk of AKI and prevent its occurrence. Correct selection of anesthetic drugs during general anesthesia, adjusted to the individual needs of patients, also infl uences the overall outcome of treatment. Nowadays, inhalational anesthetics are not considered nephrotoxic. Th e more so, inhalational anesthetics have a strong and direct protective eff ect on many organs through preconditioning and postconditioning. New studies have shown that sevofl urane diminishes ischemia/ reperfusion kidney injury and has an anti-infl ammatory eff ect, thus having the potential to reduce the occurrence of AKI. Given the incidence of AKI in the perioperative period, as well as new fi ndings about anesthetics, the issue of anesthetic selection during general anesthesia might be of crucial importance for the fi nal outcome of treatment.

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“…Kidney hypoxia or ischemia-reperfusion injury is thought to occur during the course of BP fluctuations,[8] which could occasionally develop into acute kidney injury (AKI), particularly in critically ill patients. The incidence of AKI is high (>36%) in these patients, and could even exceed 60% during the ICU stay [9]. …”

Section: Introductionmentioning

confidence: 99%

Relationship Between Short-Term Blood Pressure Variability and Incidence of Acute Kidney Injury in Critically Ill Patients

Xie

Liao

Yin

et al. 2017

Kidney Blood Press Res

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Background/Aims: Blood pressure (BP) variability is associated with cardiovascular events, and cerebral and renal damage. The aim of this study was to investigate any potential relationship between short-term BP variability and incidence of acute onset conditions, such as acute kidney injury (AKI), in critically ill patients. Methods: BP was monitored to analyze its variability in critically ill patients in present study. Short-term BP variability was assessed as average real variability (ARV), standard deviation (SD) and coefficient of variation (CV) of 24-hour BP. Results: A total of 565 patients were included, 41.2% (n=233) of which presented with AKI after admission (AKI stage I, n = 94; stage II, n = 37; stage III, n = 102). The mean APACHE II score was 21.5 for all patients. ARV of 24 h systolic BP was significantly higher in patients with AKI (p<0.001). This association remained (p=0.006) after adjustment for potential confounders. The incidence of AKI increased with the ARV from 14.0% (ARV ≤6 mmHg) to 73.9% (ARV >14 mmHg). A weak association was also found between BP variability and hospital mortality in critically ill patients. Conclusion: BP variability is correlated with the incidence of AKI in critically ill patients.

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Volatile Anesthetics and AKI

Cited by 73 publications

References 92 publications

Heme Oxygenase-1 Regulates Myeloid Cell Trafficking in AKI

Heme Oxygenase-1 Regulates Myeloid Cell Trafficking in AKI

Effect of Inhalational Anesthetics on Acute Kidney Injury

Relationship Between Short-Term Blood Pressure Variability and Incidence of Acute Kidney Injury in Critically Ill Patients

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