Glomerular haemodynamics, the renal sympathetic nervous system and sepsis-induced acute kidney injury

Abstract

Background To describe recent insights into glomerular haemodynamics in septic acute kidney injury (AKI). Methods We reviewed the literature with particular emphasis on recent findings in animal experiments and human studies in relation to renal macro- and micro-renal haemodynamics during septic AKI. Results The dominant paradigm is that septic AKI is due to decreased renal perfusion with ischaemic loss of glomerular filtration rate (GFR), ischaemic tubular cell injury and acute tubular necrosis (ATN). However, recent experimental and human studies challenge this view of the pathogenesis of septic AKI. In addition, rapid post-mortem and experimental histological studies do not support ATN as..