Rol Fisiopatológico del estrés oxidativo y la inflamación en la injuria renal aguda asociada a sepsis
Resumen
La sepsis es la primera causa de morbilidad y mortalidad en las unidades de cuidado crítico. Ésta surge como una respuesta inflamatoria severa y descontrolada contra un patógeno, en donde múltiples agentes inmunomoduladores son liberados desde una fuente primaria de infección y puede causar disfunción orgánica a distancia. La disfunción renal está presente en aproximadamente el 25 a 35% de los pacientes en unidades de cuidado intensivo de adultos, contribuyendo como factor de riesgo independiente para mortalidad. La injuria renal aguda asociada a sepsis se ha relacionado a mayores tasas de morbilidad y mortalidad, estadía hospitalaria prolongada y mayores costos asociados a cuidados de salud. Sin embargo, a pesar de los avances en investigación clínica, las terapias de reemplazo renal, y todos los tratamientos farmacológicos disponibles actualmente, la mortalidad permanece inaceptablemente elevada. Por lo tanto, los esfuerzos están enfocados en mejorar la comprensión de los mecanismos fisiopatológicos subyacentes a esta condición. Particularmente relevante es el rol de la inflamación sistémica y la alteración del estado oxidativo secundaria, los cuales determinan alteraciones microcirculatorias, disfunción celular y finalmente, falla orgánica. Así, mejorar el conocimiento acerca de esta condición patológica puede ofrecer nuevos acercamientos orientados al desarrollo de biomarcadores adecuados y nuevas intervenciones terapéuticas que puedan mejorar los outcomes en este grupo de pacientes.Palabras clave:
Sepsis, Shock séptico, Injuria Renal Aguda, Estrés oxidativo, InflamaciónReferencias
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