role of leukocytes in the pathogenesis of acute kidney injury白细胞在急性肾损伤的发病机制中的作用.pdfVIP

Kinsey and Okusa Critical Care 2012, 16:214 /content/16/2/214 R E V I E W Role of leukocytes in the pathogenesis of acute kidney injury Gilbert R Kinsey* and Mark D Okusa This article is one of eleven reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2012 (Springer Verlag, DOI: 10.1007/978-3-642-25716-2) and co-published as a series in Critical Care. Other articles in the series can be found online at /series/annualupdate2012. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from /series/8901. Introduction h is review will summarize current knowledge on the Acute kidney injury (AKI) is a signifi cant cause of role of the immune system in the pathogenesis of AKI. morbidity and mortality in hospitalized patients, especially those who are critically ill. h e mortality rate Detrimental actions of pro-infl ammatory in patients with severe AKI requiring renal replacement leukocytes therapy (RRT) can exceed 50% [1]. Numerous factors Neutrophils contribute to the development of AKI, including reduc- Polymorphonuclear cells (PMNs or neutrophils) are tions in renal blood fl ow, actions of nephrotoxic drugs, critical mediators of innate immunity. h ey respond cellular injury/death of proximal tubule epithelial cells, rapidly (within minutes) to invading pathogens and to pro-infl ammatory responses of renal endothelial cells, sites of tissue damage. Neutrophils clear invading infl ux and activation of infl ammatory leukocytes that pathogens by phagocytosis or by