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Published on: July 3, 2013
Kidney-lung connections in acute and chronic diseases: current perspectives
Luca Visconti1, Domenico Santoro1, Valeria Cernaro1
1Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
Insights
The lungs and kidneys are closely linked, impacting overall health and disease progression. Understanding these pulmonary-renal interactions is crucial for managing conditions affecting both organs.
Area of Science:
- Pulmonary and Renal Medicine
- Physiology
- Pathology
Background:
- Lung and kidney functions are intricately connected, influencing acid-base balance, blood pressure, and fluid homeostasis.
- These pulmonary-renal interactions are vital from fetal development through adulthood, impacting health and disease.
- Both organs play critical roles in maintaining physiological equilibrium.
Purpose of the Study:
- To review the complex interactions between pulmonary and renal systems.
- To explore how these interactions contribute to health and disease pathogenesis.
- To highlight the importance of interdisciplinary collaboration in managing related pathologies.
Main Methods:
- Literature review of pulmonary-renal interactions in health and disease.
- Analysis of physiological and pathological mechanisms linking lung and kidney function.
- Examination of conditions involving both organ systems, including fetal development and chronic diseases.
Main Results:
- Pulmonary and renal systems are interdependent, affecting key physiological processes.
- Interactions begin early in gestation, influencing fetal development and maturation.
- Pathological conditions can arise from primary lung or kidney disease, or through non-immunological mechanisms.
Conclusions:
- Pulmonary-renal interactions are fundamental to overall health and disease.
- A comprehensive understanding of these links is essential for effective clinical management.
- Close collaboration among intensivists, pneumologists, and nephrologists is necessary.
Abstract:
Lung and kidney functions are intimately related in both health and disease. The regulation of acid-base equilibrium, modification of partial pressure of carbon dioxide and bicarbonate concentration, and the control of blood pressure and fluid homeostasis all closely depend on renal and pulmonary activities. These interactions begin in fetal age and are often responsible for the genesis and progression of diseases. In gestational age, urine is a fundamental component of the amniotic fluid, acting on pulmonary maturation and growth. Moreover, in the first trimester of pregnancy, kidney is the main source of proline, contributing to collagen synthesis and lung parenchyma maturation. Pathologically speaking, the kidneys could become damaged by mediators of inflammation or immuno-mediated factors related to a primary lung pathology or, on the contrary, it could be the renal disease that determines a consecutive pulmonary damage. Furthermore, non immunological mechanisms are frequently involved in renal and pulmonary diseases, as observed in chronic pathologies such as sleep apnea syndrome, pulmonary hypertension, progressive renal disease and hemodialysis. Kidney damage has also been related to mechanical ventilation. The aim of this review is to describe pulmonary-renal interactions and their related pathologies, underscoring the need for a close collaboration between intensivists, pneumologists and nephrologists.
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