Kidney in sepsis

The majority of critically ill patients with multiple organ failure (MOF) associated with sepsis have acute renal failure (ARF) [1,2]. Conversely, the frequency of ARF in severe sepsis ranges from 20 to 50 % [1,2]. The chances of survival once ARF has developed in the course of sepsis are poor, despite of appropriate supporting therapy, since the mortality rate exceeds 60 % [1,2]. The kidney may be either directly or indirectly affected by sepsis. Haematologic spread of sepsis may lead to interstitial micro-abscess formation in the kidney. In animals, renal dysfunction is common after the infusion of endotoxin derived from Gram-negative bacteria or induction of bacterial sepsis [3-30]. However, not only endotoxin but other components of Gram-negative and Gram-positive bacteria may be capable of inducing ARF, and compounds differ in their renal toxicity [9,27,28,31,32].