Acute Kidney Injury
Acute Kidney Injury
Acute Kidney Injury
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Systemic Effects<br />
Renal Effects<br />
Decreased APP and<br />
Mesenteric venous outflow<br />
j tlntracinal Pressure rt<br />
~~:~~~~~~<br />
Elevated Diaphragm<br />
1' Intrathoracic pressure<br />
1' PIP<br />
1' Dead space<br />
1' PaC02<br />
.t.Pa02<br />
( Cardiovascular I<br />
Hypovolemia<br />
.t. Venous return<br />
tCVP<br />
1'PAOP<br />
1'SVR<br />
.t.CO<br />
.<br />
(vi, cycle) ) pe USion J------1--'<br />
Bowel ischemiaflnflammation<br />
Bacterial translocation<br />
Cytokine release<br />
Capillary leak & edema<br />
Portal blood flow<br />
Clinical Effects<br />
Oliguria<br />
Decreased G FR<br />
Proteinuria<br />
worsening of ischemic injury<br />
Diuretic resistance<br />
Proposed Mechanisms<br />
of Renal Dysfunction<br />
Increased renal vein pressure<br />
lrculatlon<br />
Microvascular congestion<br />
Renal vascular resistance<br />
Increased Catecholamines<br />
Increased Angiotensin II<br />
Proinflammatory cytokines<br />
Increased lntracapsular pressure<br />
(in ischemic injury)
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