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2836962 
Journal Article 
The central role of renal microcirculatory dysfunction in the pathogenesis of acute kidney injury 
Ince, C 
2014 
1 
Nephron Clinical Practice
ISSN: 1660-2110 
127 
1-4 
124-128 
English 
25343835 
WOS:000343661900025 
Acute kidney injury (AKI) is a rapidly developing condition often associated with critical illness, with a high degree of morbidity and mortality, whose pathophysiology is ill understood. Recent investigations have identified the dysfunction of the renal microcirculation and its cellular and subcellular constituents as being central to the etiology of AKI. Injury is caused by inflammatory activation involving endothelial leucocyte interactions in combination with dysregulation of the homeostatis between oxygen, nitric oxide, and reactive oxygen species. Effective therapies expected to resolve AKI will have to control inflammation and restore this homeostasis. In order to apply and guide these therapies effectively, diagnostic tools aimed at physiological biomarkers of AKI for monitoring renal microcirculatory function in advance of changes in pharmacological biomarkers associated with structural damage of the kidney will need to be developed. 
Renal failure; Microcirculation; Oxygenation; Reactive oxygen species; Nitric oxide