Norepinephrine May Exacerbate Septic Acute Kidney Injury: A Narrative Review
Highlights
- Norepinephrine is recommended as the first-line treatment for S-AKI. It increases the glomerular filtration rate, increases sodium filtration and reabsorption, boosts renal blood flow, and has no effect on urine flow or renal vascular resistance. However, norepinephrine can reduce medullary tissue oxygen by half. (View Highlight)
- Although 20% of cardiac output is delivered to the renal system, the renal medulla is vulnerable to hypoxia, likely due to vascular congestion. (View Highlight)
- It has been suggested that in S-AKI, the defects in the initial two days of the condition are more functional than structural in nature (i.e., abnormal microvasculature and tubular stress are more evident in the first 48 h than aberrant histopathology) [13]. As intrarenal perfusion is redistributed during sepsis, renal hypoxia may result, which may cause S-AKI (View Highlight)