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Acute kidney injury

Alkaline phosphatase in sepsis-induced AKI

Nature Reviews Nephrology volume 8, page 129 (2012)Cite this article

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Alkaline phosphatase may be useful for the treatment of critically ill patients who have severe sepsis or septic shock and evidence of acute kidney injury (AKI), according to a randomized, double-blinded study published in Critical Care.

“Alkaline phosphatase is able to remove phosphate from different molecules and thereby acts as a detoxifying enzyme. It is depleted in the kidney during an ischemic or inflammatory insult and shortage of such a detoxifying enzyme might be related to further renal damage during sepsis,” explains Peter Pickkers, an author on the recent trial. “We wanted to investigate whether administration of exogenous alkaline phosphatase would prevent further damage to the kidneys during sepsis, the most prevalent cause of renal damage and one for which no specific therapies are available to treat or prevent. Beneficial effects of alkaline phosphatase have been shown in animal models of sepsis, and our group has also previously reported that treatment with alkaline phosphatase is associated with decreased expression of nitric oxide in the kidneys of patients with sepsis and that this reduction is associated with an attenuation of the urinary excretion of markers of tubular injury. In our most recent study, we investigated whether administration of alkaline phosphatase resulted in a beneficial effect on clinically relevant end points of renal damage.”

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ORIGINAL RESEARCH PAPER

  1. Pickkers, P. et al. Alkaline phosphatase for treatment of sepsis-induced acute kidney injury: a prospective randomized double-blind placebo-controlled trial. Crit. Care doi:10.1186/cc11159

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  1. Rebecca Ireland
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Ireland, R. Alkaline phosphatase in sepsis-induced AKI. Nat Rev Nephrol 8, 129 (2012). https://doi.org/10.1038/nrneph.2012.1

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