Sepsis-associated acute kidney injury

Acute kidney injury (AKI) is a condition that develops as result of rapid decrease in the glomerular filtration rate, which leads to accumulation nitrogenous, including urea and creatinine, non-nitrogenous metabolic products with electrolytic disorders, impairment acid-base balance, volume fluid excreted by kidneys. Objective: provide review literature concerning sepsis-associated acute injury. We presented problems diagnosis, risk factors, pathogenesis injury, well outline terminologically clinical form injury: paradigm shifts from ischemia vasoconstriction hyperemia vasodilation, tubular necrosis apoptosis. Sepsis contributes significantly development AKI: sepsis, it occurs 19 % patients; nevertheless, much more frequent septic shock (45 cases), mortality individuals AKI especially high non-septic conditions 73 %, respectively). To effectively diagnose functional state kidneys conduct nephroprotective therapy, stratification scales for assessing severity damage are applied, based on determination plasma creatinine level urine output: RIFLE (risk, failure, loss function, end-stage renal failure), AKIN (Acute Kidney Injury Network), KDIGO (Kidney Disease Improving Global Outcomes); experts considered scale modern perfect. It has been found not an early biomarker indicates advisability using other integral indicators. biomarkers substances either participate pathological process or witness allowing even before increase level. The characteristics structure, role functions such neutrophil gelatinase-associated lipocalin, cystatin C, interleukin-18, molecule-1 others given. Intensive care includes standard therapy corresponding 2016 Surviving Campaign guidelines. Also, paper focuses replacement (RRT): extrarenal indications initiation, factors affecting initiation RRT, timing ways optimization, RRT discontinuation, recommendations dose AKI, choice method, advantages disadvantages continuous intermittent hemodialysis, medication support hemodialysis machine intensive unit.