Organ crosstalk: The role of the kidney

Xiang Li, Heitham T Hassoun, Rachel Santora, Hamid Rabb

Research output: Contribution to journalArticle

Abstract

Purpose of review: Acute kidney injury (AKI) continues to contribute significantly to morbidity and mortality in the ICU setting, especially when associated with distant organ dysfunction. There is increasing evidence that AKI directly contributes to organ dysfunction in lung, brain, liver, heart and other organs. This review will examine our current understanding of the deleterious organ crosstalk in the critically ill, which can provide a framework for developing novel therapeutics. Recent findings: The majority of studies correlating AKI with distant organ dysfunction have demonstrated the pathophysiological importance of proinflammatory and proapoptotic pathways as well as oxidative stress and reactive oxygen species (ROS) production. Leukocyte activation and infiltration, changes in levels of soluble factors such as cytokines and chemokines, and regulation of cell death in extra-renal organs are potentially important mechanisms by which AKI modulates multiorgan dysfunction. Summary: There is increasing knowledge of AKI and deleterious interorgan crosstalk that arises, at least in part, due to the imbalance of immune, inflammatory, and soluble mediator metabolism that attends severe insults to the kidney. Further studies can build on these new mechanistic observations to develop strategies to improve outcomes in the critically ill patient.

Original languageEnglish (US)
Pages (from-to)481-487
Number of pages7
JournalCurrent Opinion in Critical Care
Volume15
Issue number6
DOIs
StatePublished - Dec 2009

Fingerprint

Acute Kidney Injury
Kidney
Critical Illness
Chemokines
Reactive Oxygen Species
Oxidative Stress
Leukocytes
Cell Death
Cytokines
Morbidity
Lung
Mortality
Liver
Brain
Therapeutics

Keywords

  • Acute kidney injury
  • Distant organ injury
  • Inflammation
  • Ischemia/reperfusion

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Organ crosstalk : The role of the kidney. / Li, Xiang; Hassoun, Heitham T; Santora, Rachel; Rabb, Hamid.

In: Current Opinion in Critical Care, Vol. 15, No. 6, 12.2009, p. 481-487.

Research output: Contribution to journalArticle

Li, Xiang ; Hassoun, Heitham T ; Santora, Rachel ; Rabb, Hamid. / Organ crosstalk : The role of the kidney. In: Current Opinion in Critical Care. 2009 ; Vol. 15, No. 6. pp. 481-487.
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