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Renal vascular resistance in sepsis
Christoph Langenberg1, Rinaldo Bellomo, Clive N May
1Departments of Intensive Care and Medicine, Austin Hospital and University of Melbourne, Heidelberg, Melbourne, Australia.
Nephron. Physiology
|May 13, 2006
Summary
Human studies on renal vascular resistance (RVR) in sepsis are lacking. In experimental sepsis, RVR is influenced by animal size and cardiac output, not sepsis severity itself.
Area of Science:
- Nephrology
- Critical Care Medicine
- Physiology
Background:
- Sepsis can lead to acute kidney injury.
- Renal vascular resistance (RVR) plays a critical role in kidney function during sepsis.
- Understanding RVR determinants is crucial for managing septic patients.
Purpose of the Study:
- To systematically review changes in RVR during human and experimental sepsis.
- To identify factors influencing RVR in sepsis.
Main Methods:
- Systematic literature search of two electronic databases.
- Inclusion of animal and human studies assessing RVR in sepsis.
- Statistical analysis to identify determinants of RVR.
Main Results:
- No human studies accurately measured RVR in sepsis.
- In 137 animal studies, 69 showed increased RVR, 52 decreased RVR, and 16 no change.
- Multivariate analysis identified animal size and cardiac output as independent determinants of RVR.
Conclusions:
- RVR changes in human sepsis remain unknown.
- In experimental sepsis, animal size and cardiac output significantly influence RVR.
- Large animals and high cardiac output are associated with decreased RVR; small animals and low cardiac output with increased RVR.
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