Pathways of renal injury in systemic gram-negative sepsis

Research output: Contribution to journalReview article

41 Scopus citations


Acute renal failure is a grave complication of systemic gram-negative sepsis. The pathophysiological mechanisms of sepsis leading to kidney injury result in part from systemic inflammatory and haemodynamic alterations. These are triggered by the interaction of endotoxin with Toll-like receptor 4 (TLR4) on cells of the immune system. Recently, TLR4 and other co-effector molecules were identified on renal tubular and vascular cells. Furthermore, it was demonstrated that systemic endotoxin has direct access to renal sites where these receptors are expressed. Therefore, we review data in support of this novel pathway of renal injury in sepsis, whereby systemic endotoxin causes direct injury through interactions with local epithelial and endothelial TLR4.

Original languageEnglish (US)
Pages (from-to)39-44
Number of pages6
JournalEuropean Journal of Clinical Investigation
Issue numberSUPPL.2
StatePublished - Oct 1 2008


  • Acute kidney injury
  • Acute renal failure
  • Endotoxin
  • TLR4
  • Toll-like receptors

ASJC Scopus subject areas

  • Medicine(all)
  • Clinical Biochemistry
  • Biochemistry

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