Editorial Views  |   August 2018
Natriuretic Peptides: A Role in Early Septic Acute Kidney Injury?
Author Notes
  • From the Bloomsbury Institute of Intensive Care Medicine, Division of Medicine, University College London, London, United Kingdom (N.A.); the Critical Care and Perioperative Medicine Research Group, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom (J.R.P.); and the Adult Critical Care Unit and Department of Renal Medicine and Transplantation, The Royal London Hospital, Barts Health National Health Service Trust, London, United Kingdom (J.R.P.).
  • Corresponding article on page 296.
    Corresponding article on page 296.×
  • Accepted for publication May 7, 2018.
    Accepted for publication May 7, 2018.×
  • Address correspondence to Dr. Prowle: j.prowle@qmul.ac.uk
Article Information
Editorial Views / Critical Care / Renal and Urinary Systems / Electrolyte Balance
Editorial Views   |   August 2018
Natriuretic Peptides: A Role in Early Septic Acute Kidney Injury?
Anesthesiology 8 2018, Vol.129, 235-237. doi:10.1097/ALN.0000000000002307
Anesthesiology 8 2018, Vol.129, 235-237. doi:10.1097/ALN.0000000000002307
Acute kidney injury is a common complication of critical illness and is associated with significant morbidity, mortality, and financial cost. Sepsis is the leading association of acute kidney injury in the intensive care unit and is implicated in more than half the cases.1  Our understanding of the pathogenesis of sepsis-associated acute kidney injury continues to evolve. Current evidence suggests that pathways involving inflammatory injury to the renal tubules and microcirculation play a leading role in the development of the acute kidney injury syndrome, and these mechanisms may be dissociated from sepsis-induced changes in systemic hemodynamics.2,3  Reflecting our poor understanding of this complex syndrome, we lack any specific treatment for the prevention or resolution of septic acute kidney injury other than supportive care. In this issue of Anesthesiology, Kitamura et al.4  present findings in an animal model of lipopolysaccharide administration that adds to our understanding of the pathogenesis of sepsis-associated acute kidney injury and the tubular cell dysfunction that is its pathologic hallmark. Furthermore, these findings support further investigation of natriuretic peptides in early sepsis as agents that could modify tubular function and ameliorate the wider effects of endotoxin on the microcirculation.
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