What happens to the kidneys during sepsis?
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What triggers sepsis‑associated acute kidney injury and why is early recognition crucial?
we're starting to understand both on the very acute and also on the recovery side that actually probably less dialysis is better overall for the patients, but that we do have to intervene in a timely manner, right? Because delaying it too long, right, there there's this kind of like um sweet spot kind of goldilocks kind of period. Yeah, sweet spot. Too early or too late can actually be counterproductive.
This is the Sepsis Spectrum, a podcast about antimicrobial resistance, sepsis, and how to expect the unexpected in your practice.
My name is Josh Woodward. And Chelsea. This is my wife Chelsea Woodward. And I'm going to talk a little bit about our sepsis journey today. I remember right around February, maybe second or third, uh, I clocked out of the firehouse one day. I was feeling a little bit under the weather, um, but I wasn't really alarmed. I was, you know, had a low grade fever of maybe 99. Um, so not too terrible, a couple of aches. And I had a spot in my right armpit right in here. Uh, as the days progressed, uh, things kind of started to get Worse. There's another spot on my ribs. Um, and that spot is the same thing. It's red and it's swollen and and kind of painful. So You know, my wife came down, she saw it around five AM. I was still awake.
She's like, why don't we just take you to the ER? I remember one of the first signs I noticed, um, that I didn't realize it at the time, but looking back on it, I always mention it because um I I used the restroom before I went to the ER. And I remember that night I didn't sleep and I drank like over a gallon of water, feeling so thirsty, but never having to feel like I had to use the bathroom. And I I went to use the bathroom before. I went to the hospital and my urine was like dark, like as dark as I've ever seen it, like like iced tea, like brown. Um, so I was like, Well, that's kind of alarming. So I got checked into the hospital. Um You know, next thing you know, uh the doctor's coming in telling me that I'm going into septic shock and they need to operate on me right away.
And that would be about a two to three hour surgery to open up some of the infected tissue and and see what was going on. Um, I said okay, but I woke up not two to three hours later. I woke up ten days later. Uh ten days later, thinking it was the same day. So as it stands now, I'm a double amputee. Um As far as kidney treatments go, I had some pretty severe, pretty severe kidney issues going into it. I thought I was going to be on dialysis for a long time. Um, I was on dialysis seven days a week for roughly three or four weeks while I was in the hospital. Luckily, um, when I when I got out of the hospital, I didn't need uh dialysis anymore. But I have been much more conscious of the things I drink, how I continue to take care of my body.
If you're worried you have sepsis, um, this is your life, this is your body. So take the initiative, go to the hospital. And if you're worried about them missing it or like missing something or passing off as a flu, just say out loud, like say it to the nurse, like, hey, I'm I'm worried this might be sepsis. You know, um just getting that out there will really get get things in motion and get things moving along.
Hi everyone and welcome to the sepsis spectrum. I'm Nicole Kupchik, critical care nurse, clinical nurse specialist, and your guide through the unpredictable world of sepsis, or as we like to call this season, sepsis and multi-organ dysfunction. Today, we're turning our attention to one of the body's most silent but vital players, the kidneys. More specifically, taking a close look at the relationship between sepsis and kidney injury, and how infection, inflammation, and fluid shifts can quietly overwhelm one of the body's most resilient organs. The clip we just played was from Josh. Josh is a firefighter and sepsis survivor. Who went from a few red spots on his skin to full-blown septic shock in just a matter of days?
His kidneys failed, his body shut down, and for weeks he relied on dialysis to survive. Josh's story is a huge reminder that when the kidneys falter, it's not just a lab value in a chart, it's a turning point.
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Chapters
8 chapters
1
What triggers sepsis‑associated acute kidney injury and why is early recognition crucial?
0:00–5:41
2
How does the patient’s personal sepsis story illustrate the rapid progression to AKI?
5:41–12:29
3
What are the main pathophysiologic mechanisms behind kidney damage in sepsis?
12:29–17:41
4
Which medications used in sepsis treatment can worsen kidney injury and how should they be managed?
17:41–23:28
5
Why do creatinine levels lag behind kidney injury and what newer biomarkers could improve detection?
23:28–29:38
6
How should fluid resuscitation be balanced to avoid overload and the need for dialysis?
29:38–35:21
7
When is it optimal to start renal replacement therapy (CRRT vs. HD) in septic AKI?
35:21–40:41
8
What emerging therapies and future research directions could change sepsis‑related AKI outcomes?
40:41–46:06