AUTHOR=Muciño-Bermejo Maria-Jimena 

TITLE=Extracorporeal organ support and the kidney

JOURNAL=Frontiers in Nephrology

VOLUME=Volume 2 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/nephrology/articles/10.3389/fneph.2022.924363

DOI=10.3389/fneph.2022.924363

ISSN=2813-0626

ABSTRACT=The term extracorporeal organ support (ECOS) includes all forms of extracorporeal organ support, encompassing kidney, respiratory, cardiac and liver support. 

In an era  of increasing  incidence and  survival  of  patients with single or multiple organ failure, knowledge on  both  multiorganic crosstalk and  native organ-extracorporeal support interactions  have become  increasingly important.

Immerse within the cross-talk of multiple organ failure (MOF), Acute  kidney  injury (AKI) may be  a part of  the  clinical  presentation  in  patients  undergoing  ECOS, either as a  concurrent  clinical issue  since the  very  start of  ECOS or as  a  de novo  event  at  any point in the  clinical  course.

At  any point during the clinical course  of a patient with  single  or  multiple  organ failure  undergoing ECOS, renal function may improve or deteriorate, as  a result of the  interaction of multiple factors, including multiorganic crosstalk  and or native organ/ECOS interactions.

Besides multiorgan crosstalk  during MOF, the main  common physiopathological  ways  in  which ECOS may influence  renal  function includes: 1)Hemodynamic changes,  2)Neurohumoral changes,  3)Cytokine profile switch,   4)ECOS-associated  coagulation abnormalities, 5)Toxin/drugs clearance and 6) Circuit-related factors.
The main aim of this review is to summarize the described mechanisms influencing the  renal function during the course of  ECOS,  including hemodialysis, hemofiltration, venovenous extracorporeal membrane oxygenation, venoarterial extracorporeal membrane oxygenation, extracorporeal carbon dioxide  removal and albumin dialysis.