Mediators of Regional Kidney Perfusion during Surgical Pneumo-Peritoneum Creation and the Risk of Acute Kidney Injury—A Review of Basic Physiology
Acute kidney injury (AKI), especially if recurring, represents a risk factor for future chronic kidney disease. In intensive care units, increased intra-abdominal pressure is well-recognized as a significant contributor to AKI. However, the importance of transiently increased intra-abdominal pressur...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-05-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/10/2728 |
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| author | Csaba Kopitkó László Medve Tibor Gondos Karim Magdy Mohamed Soliman Tibor Fülöp |
| author_facet | Csaba Kopitkó László Medve Tibor Gondos Karim Magdy Mohamed Soliman Tibor Fülöp |
| author_sort | Csaba Kopitkó |
| collection | DOAJ |
| description | Acute kidney injury (AKI), especially if recurring, represents a risk factor for future chronic kidney disease. In intensive care units, increased intra-abdominal pressure is well-recognized as a significant contributor to AKI. However, the importance of transiently increased intra-abdominal pressures procedures is less commonly appreciated during laparoscopic surgery, the use of which has rapidly increased over the last few decades. Unlike the well-known autoregulation of the renal cortical circulation, medulla perfusion is modulated via partially independent regulatory mechanisms and strongly impacted by changes in venous and lymphatic pressures. In our review paper, we will provide a comprehensive overview of this evolving topic, covering a broad range from basic pathophysiology up to and including current clinical relevance and examples. Key regulators of oxidative stress such as ischemia-reperfusion injury, the activation of inflammatory response and humoral changes interacting with procedural pneumo-peritoneum formation and AKI risk will be recounted. Moreover, we present an in-depth review of the interaction of pneumo-peritoneum formation with general anesthetic agents and animal models of congestive heart failure. A better understanding of the relationship between pneumo-peritoneum formation and renal perfusion will support basic and clinical research, leading to improved clinical care and collaboration among specialists. |
| first_indexed | 2024-03-10T03:40:40Z |
| format | Article |
| id | doaj.art-9b440bd3e73b4576b90a6529798ea22e |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T03:40:40Z |
| publishDate | 2022-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-9b440bd3e73b4576b90a6529798ea22e2023-11-23T11:33:53ZengMDPI AGJournal of Clinical Medicine2077-03832022-05-011110272810.3390/jcm11102728Mediators of Regional Kidney Perfusion during Surgical Pneumo-Peritoneum Creation and the Risk of Acute Kidney Injury—A Review of Basic PhysiologyCsaba Kopitkó0László Medve1Tibor Gondos2Karim Magdy Mohamed Soliman3Tibor Fülöp4Department of Anesthesiology and Intensive Therapy, Uzsoki Teaching Hospital, Semmelweis University, H-1145 Budapest, HungaryDepartment of Anesthesiology and Intensive Therapy, Markhot Ferenc Teaching Hospital, H-3300 Eger, HungaryDoctoral School of Pathological Sciences, Semmelweis University, H-1088 Budapest, HungaryDepartment of Medicine, Division of Nephrology, Medical University of South Carolina, Charleston, SC 29425, USADepartment of Medicine, Division of Nephrology, Medical University of South Carolina, Charleston, SC 29425, USAAcute kidney injury (AKI), especially if recurring, represents a risk factor for future chronic kidney disease. In intensive care units, increased intra-abdominal pressure is well-recognized as a significant contributor to AKI. However, the importance of transiently increased intra-abdominal pressures procedures is less commonly appreciated during laparoscopic surgery, the use of which has rapidly increased over the last few decades. Unlike the well-known autoregulation of the renal cortical circulation, medulla perfusion is modulated via partially independent regulatory mechanisms and strongly impacted by changes in venous and lymphatic pressures. In our review paper, we will provide a comprehensive overview of this evolving topic, covering a broad range from basic pathophysiology up to and including current clinical relevance and examples. Key regulators of oxidative stress such as ischemia-reperfusion injury, the activation of inflammatory response and humoral changes interacting with procedural pneumo-peritoneum formation and AKI risk will be recounted. Moreover, we present an in-depth review of the interaction of pneumo-peritoneum formation with general anesthetic agents and animal models of congestive heart failure. A better understanding of the relationship between pneumo-peritoneum formation and renal perfusion will support basic and clinical research, leading to improved clinical care and collaboration among specialists.https://www.mdpi.com/2077-0383/11/10/2728acute kidney injuryintra-abdominal pressureoxidative stressrenal cortical blood flowrenal medullar blood flowrenal lymphatic drainage |
| spellingShingle | Csaba Kopitkó László Medve Tibor Gondos Karim Magdy Mohamed Soliman Tibor Fülöp Mediators of Regional Kidney Perfusion during Surgical Pneumo-Peritoneum Creation and the Risk of Acute Kidney Injury—A Review of Basic Physiology Journal of Clinical Medicine acute kidney injury intra-abdominal pressure oxidative stress renal cortical blood flow renal medullar blood flow renal lymphatic drainage |
| title | Mediators of Regional Kidney Perfusion during Surgical Pneumo-Peritoneum Creation and the Risk of Acute Kidney Injury—A Review of Basic Physiology |
| title_full | Mediators of Regional Kidney Perfusion during Surgical Pneumo-Peritoneum Creation and the Risk of Acute Kidney Injury—A Review of Basic Physiology |
| title_fullStr | Mediators of Regional Kidney Perfusion during Surgical Pneumo-Peritoneum Creation and the Risk of Acute Kidney Injury—A Review of Basic Physiology |
| title_full_unstemmed | Mediators of Regional Kidney Perfusion during Surgical Pneumo-Peritoneum Creation and the Risk of Acute Kidney Injury—A Review of Basic Physiology |
| title_short | Mediators of Regional Kidney Perfusion during Surgical Pneumo-Peritoneum Creation and the Risk of Acute Kidney Injury—A Review of Basic Physiology |
| title_sort | mediators of regional kidney perfusion during surgical pneumo peritoneum creation and the risk of acute kidney injury a review of basic physiology |
| topic | acute kidney injury intra-abdominal pressure oxidative stress renal cortical blood flow renal medullar blood flow renal lymphatic drainage |
| url | https://www.mdpi.com/2077-0383/11/10/2728 |
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