Kidney Damage After Sepsis: A Long-term Follow-up. An Experimental Study.

Abstract Background: Acute kidney injury (AKI) in sepsis is a common event. This study aims to evaluate the long-term impact of sepsis on renal hemodynamics and morphology. Methods: Wistar rats underwent sepsis and survivors (n = 24) were followed for up to six months, monitoring macro, regional and micro hemodynamics of the kidney, serum creatinine, and renal histology. The naive animals were used as the control group (n= 6), and sepsis was induced by E. coli e.v. inoculation. Surviving animals were monitored for up to six months. Results: Overall, the findings show that sepsis survivors have long-term hemodynamic and morphological compromise, as well as a progressive worsening of renal functional unit components over time. Even after six months of recovery from sepsis, severe renal hypoxia, chronic inflammation, evidence of increased vascular resistance, and renal fibrosis were observed in surviving animals. These alterations were present in animals with a healthy appearance and normal MAP. Conclusion: Those findings may represent a state of severely impaired physiology and be a contributing factor to the higher susceptibility to renal failure in the face of a new infectious challenge or to other pathological stimuli in the post-sepsis periods.