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[Interactions between lung and kidney in the critically ill].

S J Klein1, F Husain-Syed2, C Karagiannidis3

  • 1Gemeinsame Einrichtung Internistische Intensiv- und Notfallmedizin, Department für Innere Medizin, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich.

Medizinische Klinik, Intensivmedizin Und Notfallmedizin
|August 11, 2018
PubMed
Summary

The lungs and kidneys significantly impact each other during critical illness. Acute kidney injury (AKI) can cause lung injury, while lung issues can lead to AKI, both increasing mortality.

Keywords:
Acute kidney injuryAcute respiratory distress syndromeInflammation mediatorsMechanical ventilationPathophysiology

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Area of Science:

  • Critical care medicine
  • Nephrology
  • Pulmonology

Background:

  • The interplay between lung and kidney function in acute diseases is a recognized clinical phenomenon.
  • Acute kidney injury (AKI) is linked to remote lung injury, increasing risks of pulmonary edema and acute respiratory distress syndrome (ARDS).
  • Co-occurring ARDS and AKI worsen patient outcomes, including higher mortality rates.

Purpose of the Study:

  • To examine the bidirectional interactions between the lung and kidney in critically ill patients.
  • To discuss potential preventive strategies for lung-kidney crosstalk in critical care.

Main Methods:

  • Review of existing literature on lung-kidney interactions in acute diseases.
  • Analysis of clinical observations and animal experimental evidence.
  • Exploration of pathophysiological mechanisms involved in organ crosstalk.

Main Results:

  • Acute lung diseases and mechanical ventilation can precipitate AKI.
  • Bidirectional interactions involve hemodynamic changes, volume overload, and inflammatory mediator dysregulation.
  • Proinflammatory mediators like IL-6 and TNF-α contribute to distant organ injury.

Conclusions:

  • Lung-kidney interactions are critical in critically ill patients, influencing disease severity and outcomes.
  • Understanding these interactions is key to developing effective preventive and therapeutic strategies.
  • Further research into preventive approaches for lung-kidney crosstalk is warranted.