First Medical Department, Charles University Medical School and Teaching Hospital, Plzeň, Czech Republic.
Physiol Res. 2010;59(6):859-869. doi: 10.33549/physiolres.931936. Epub 2010 Jun 9.
The kidney is a common "victim organ" of various insults in critically ill patients. Sepsis and septic shock are the dominant causes of acute kidney injury, accounting for nearly 50 % of episodes of acute renal failure. Despite our substantial progress in the understanding of mechanisms involved in septic acute kidney injury there is still a huge pool of questions preclusive of the development of effective therapeutic strategies. This review briefly summarizes our current knowledge of pathophysiological mechanisms of septic acute kidney injury focusing on hemodynamic alterations, peritubular dysfunction, role of inflammatory mediators and nitric oxide, mitochondrial dysfunction and structural changes. Role of proteomics, new promising laboratory method, is mentioned.
肾脏是各种危重病患者各种损伤的常见“靶器官”。脓毒症和感染性休克是急性肾损伤的主要原因，占急性肾衰竭发作的近 50%。尽管我们在理解脓毒症急性肾损伤的机制方面取得了实质性进展，但仍有大量问题阻碍了有效治疗策略的发展。这篇综述简要总结了我们目前对脓毒症急性肾损伤的病理生理机制的认识，重点介绍了血流动力学改变、肾小管周围功能障碍、炎症介质和一氧化氮的作用、线粒体功能障碍和结构变化。还提到了蛋白质组学这一新的有前途的实验室方法的作用。
