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Technical Refinement of a Bilateral Renal Ischemia-Reperfusion Mouse Model for Acute Kidney Injury Research
Published on: November 3, 2023
Continuous renal replacement therapy in sepsis and multisystem organ failure
1Intensive Care Unit, Department of Internal Medicine I, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, Austria. michael.joannidis@i-med.ac.at
Seminars in Dialysis
|May 12, 2009
Summary
Continuous renal replacement therapy (CRRT) supports kidney function in sepsis-induced acute kidney injury (AKI). Modified CRRT techniques aim to modulate the immune response by influencing inflammatory mediators and coagulation factors.
Area of Science:
- Critical Care Medicine
- Nephrology
- Immunology
Background:
- Sepsis-induced acute kidney injury (AKI) and septic shock often lead to multiple organ failure.
- Continuous renal replacement therapy (CRRT) is a standard treatment for AKI in critically ill patients.
- Emerging evidence suggests CRRT may also modulate the immune response in sepsis.
Purpose of the Study:
- To review the multifaceted role of CRRT in sepsis.
- To explore modifications of CRRT aimed at immune modulation.
- To discuss novel concepts in CRRT for sepsis management.
Main Methods:
- Literature review of studies on CRRT in sepsis, AKI, and septic shock.
- Analysis of CRRT modifications targeting inflammatory mediators, complement, and coagulation.
- Evaluation of emerging renal assist device concepts.
Main Results:
- CRRT primarily supports renal function in AKI.
- Modified CRRT strategies (e.g., high volume hemofiltration, high cut-off membranes) aim to reduce inflammatory mediators.
- Novel approaches like coupled plasma filtration absorbance and bio-artificial devices are under investigation.
Conclusions:
- CRRT plays a dual role in sepsis: renal support and potential immune modulation.
- CRRT modifications offer promising avenues for managing sepsis-associated inflammation.
- Future research may focus on bio-integrated renal assist devices for enhanced sepsis treatment.
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