• Lara Zafrani, Didier Payen, Elie Azoulay, and Can Ince.
• Department of Translational Physiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Electronic address: lara.zafrani@sls.aphp.fr.
• Semin. Nephrol. 2015 Jan 1;35(1):75-84.

AbstractThe renal microcirculation plays a major role in the delivery of blood and oxygen to the kidney. In sepsis, alterations in renal microvascular perfusion, in conjunction with increased oxygen requirements, may contribute to renal failure even when renal macrovascular perfusion is preserved. In this review, we discuss the pathophysiology of the renal microcirculation during sepsis and how it contributes to acute kidney injury. Endothelial dysfunction largely is owing to inflammatory, oxidative, and nitrosative factors. Coagulative disorders and glycocalyx disruption also may contribute to the microcirculatory dysfunction. New technologies in experimental models and human beings are being developed to explore renal microcirculation in vivo. These technologies will allow a better understanding of the pathophysiopathology of the renal microcirculation and will help guide specific therapeutic strategies in sepsis-induced acute kidney injury.Copyright © 2015 Elsevier Inc. All rights reserved.

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