The pathogenesis of renal injury in obstructive jaundice: A review of underlying mechanisms, inducible agents and therapeutic strategies. (January 2021)

• Record Type: Journal Article
• Authors: Liu, Jiayue; Qu, Jialin; Chen, Haiyang; Ge, Peng; Jiang, Yuankuan; Xu, Caiming; Chen, Hailong; Shang, Dong; Zhang, Guixin
• Is Part Of: Pharmacological research. Volume 163(2021)
• Publication Date: 2021-01
• Subjects: OJ obstructive jaundice -- MODS multiple organ dysfunction syndrome -- OJKI obstructive jaundice kidney injury -- CN bile cast nephropathy -- ARF acute renal failure -- CKD chronic kidney disease -- CBDL common bile-duct ligation -- BDL bile duct ligation -- BAs bile acids -- GFR glomerular filtration rate -- OS Oxidative stress -- ROS Reactive oxygen species -- OFR oxygen free radicals -- BSP bromosulphide -- MRP2 multidrug resistance protein 2 -- NaDC1 dicarboxylate cotransporter 1 -- LPS lipopolysaccharide -- DEX dexmedetomidine -- ECW extracellular water volume -- ANP atrial natriuretic peptide -- (TXA2) thromboxane A2 -- PGE2 Prostaglandin E2 -- RAAS Rein-angiotensin-aldosterone system -- ACE2 angiotensin converting enzyme 2 -- BRS baroreflex sensitivity -- SP Spironolactone -- GM Gentamicin -- NAC N-acetylcysteine -- Nod2 Nucleotide-binding oligomerization domain-containing protein 2; Obstructive jaundice -- Hepatorenal syndrome -- Acute kidney injury -- Bile acids -- Hemodynamic disturbances; Pharmacology -- Periodicals; Pharmacology -- Periodicals; Research -- Periodicals; Médicaments -- Recherche -- Périodiques; Pharmacologie -- Périodiques; 615.105
• DOI: 10.1016/j.phrs.2020.105311
• Languages: English
• ISSNs: 1043-6618

Abstract

Graphical abstract: Abstract: Kidney injury is one of the main complications of obstructive jaundice (OJ) and its pathogenesis has not been clarified. As an independent risk factor for OJ associated with significant morbidity and mortality, it can be mainly divided into two types of morphological injury and functional injury. We called these dysfunctions caused by OJ-induced kidney injury as OJKI. However, the etiology of OJKI is still not fully clear, and research studies on how OJKI becomes a facilitated factor of OJ are limited. This article reviews the underlying pathological mechanism from five aspects, including metabolisms of bile acids, hemodynamic disturbances, oxidative stress, inflammation and the organic transporter system. Some nephrotoxic drugs and measures that can enhance or reduce the renal function with potential intervention in perioperative periods to alleviate the incidence of OJKI were also described. Furthermore, a more in-depth study on the pathogenesis of OJKI from multiple aspects for exploring more targeted treatment measures were further put forward, which may provide new methods for the prevention and treatment of clinical OJKI and improve the prognosis.