Kidney-lung crosstalk in the critically ill patient

Gang Jee Ko, Hamid Rabb, Heitham T. Hassoun

Research output: Contribution to journalReview article

72 Citations (Scopus)

Abstract

Despite advances in renal replacement therapy, the mortality of acute kidney injury (AKI) has remained high, especially when associated with distant organ dysfunction such as acute lung injury (ALI). Mortality rates for combined AKI/ALI reach 80% in critically ill patients. While the clinical presentation of AKI-associated ALI is characterized by increased pulmonary edema, a defining feature of the syndrome, the AKI-induced lung effects extend beyond simple volume overload. Furthermore, ALI and associated mechanical ventilation frequently lead to a decline in renal hemodynamics, structure and function. New experimental data have emerged in recent years focusing on the interactive effects of kidney and lung dysfunction, and these studies have highlighted the pathophysiological importance of proinflammatory and proapoptotic pathways as well as the complex nature of interorgan crosstalk. This review will examine our current understanding of the deleterious kidney-lung crosstalk in the critically ill.

Original languageEnglish
Pages (from-to)75-83
Number of pages9
JournalBlood Purification
Volume28
Issue number2
DOIs
Publication statusPublished - 2009 Aug 1
Externally publishedYes

Keywords

  • Acute kidney injury
  • Acute lung injury
  • Apoptosis
  • Ischemia/reperfusion

ASJC Scopus subject areas

  • Nephrology
  • Hematology

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