Читать книгу Current Perspectives in Kidney Diseases - Группа авторов - Страница 16

The pathophysiology of sepsis is complex, and renal dysfunction does not simply result from ischemia/hypoperfusion but rather holds a set of inflammation, microcirculatory dysfunction, perfusion deficit, bio-energetic reactions and tubular cell adaptation to injury [34]. The main purpose of blood purification therapies should be to restore homeostasis: as a matter of fact, most sepsis mediators are water-soluble and fall into the “middle-molecular weight” category (about 5–50 kDa) that can be theoretically removed by RRT via convection, diffusion or adsorption. On this basis, we can speculate that RRT can modulate the immune response to sepsis. Furthermore, RRT may have additional clinical benefits including thermal balance, cardiac support achieved by optimization of fluid balance and adequate levels of preload and afterload, protective lung support by the reduction of edema, brain protection with preservation of cerebral perfusion, liver and bone marrow support via the clearance of specific toxins [35].