Davenport Andrew
UCL Center for Nephrology, Royal Free and University College Medical School, London, UK.
Blood Purif. 2008;26(6):526-36. doi: 10.1159/000167800. Epub 2008 Nov 6.
The kidney and the brain play a major role in maintaining normal homeostasis of the extracellular fluid, and as such regulate intracellular volume, by controlling sodium and water balance. However, both hyponatraemic and hypernatraemic states commonly account for acute medical admissions, and also frequently occur during hospital in-patient stays. Both acute and chronic kidney damage can not only affect sodium and water homeostasis, but also the accumulation of uremic toxins; impairs cerebral higher functions and the ability of the brain to adapt to extracellular changes. Acute brain injury, leading to brain stem death, leads to a cytokine storm, inducing inflammation in cadaveric organs used for transplantation, with increased risk of delayed graft function and acute rejection.
肾脏和大脑在维持细胞外液的正常稳态中起主要作用,因此通过控制钠和水平衡来调节细胞内体积。然而,低钠血症和高钠血症状态通常是急性医疗入院的常见原因,并且在住院期间也经常发生。急性和慢性肾损伤不仅会影响钠和水平衡,还会影响尿毒症毒素的积累;损害大脑的高级功能以及大脑适应细胞外变化的能力。导致脑干死亡的急性脑损伤会引发细胞因子风暴,在用于移植的尸体器官中引发炎症,增加移植肾功能延迟和急性排斥反应的风险。