Abstract:
Sepsis is an important cause of morbidity and mortality. Acute Kidney Injury
(AKI) often complicates sepsis, leading to greater complexity, higher cost of
care and worsening prognosis. Despite the improved understanding of its
underlying pathophysiological basis, there have been very few interventions,
which have consistently been shown to be of value in the management of
sepsis-induced AKI. Measures such as adequate hydration, maintenance of adequate
circulating blood volume and mean arterial pressure, and avoidance of
nephrotoxins, are still the mainstay of prevention. Loop diuretics, mannitol and
"low dose" dopamine have been clearly shown to be of no value in the prevention
or treatment of AKI and may, in fact, do harm. Among the remaining
pharmacological options, N-acetylcysteine (NAC) may have a role in the prevention
of radiocontrast induced AKI.
