ArticleCritical care (London, England)2010
Renin-angiotensin system activation correlates with microvascular dysfunction in a prospective cohort study of clinical sepsis.
Article in Critical care (London, England), 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
59 citing papers in PubMed, 122 citations in OpenAlex.
- Trial
- Renin aldosterone vasopressin and copeptin kinetics in patients with septic shock, a post-hoc Hyper2S randomized trial analysis.Intensive care medicine · 2020Trial
- A pilot clinical trial of recombinant human angiotensin-converting enzyme 2 in acute respiratory distress syndrome.Critical care (London, England) · 2017Trial
- Pediatric sepsis-associated acute kidney injury: leveraging pathophysiology for risk stratification and identification of treatable traits.Pediatric nephrology (Berlin, Germany) · 2026Review
- The Importance of Plasma Renin Concentrations in Intensive Care Patients with Circulatory Shock.Journal of clinical medicine · 2026Article
- ATPflugers Archiv : European journal of physiology · 2025Article
- Angiotensin II Type 2 Receptor Inhibits M1 Polarization and Apoptosis of Alveolar Macrophage and Protects Against Mechanical Ventilation-Induced Lung Injury.Inflammation · 2025Article
- Screening and Identification of Neutrophil Extracellular Trap-related Diagnostic Biomarkers for Pediatric Sepsis by Machine Learning.Inflammation · 2025Article
- Circulating angiotensin-converting enzyme 2 concentration is associated with acute kidney injury and mortality in sepsis.PloS one · 2025Article
- Diagnostic Accuracy of Plasma Renin Concentration and Renin Activity in Predicting Mortality and Kidney Outcomes in Patients With Septic Shock and Hypoperfusion or Hypotension: A Multicenter, Prospective, Observational Study.Annals of laboratory medicine · 2024Observational
- Losartan as a Reproposing Therapeutic Agent in Acute Respiratory Distress Syndrome: Modulating Inflammatory Responses and Cytokine Production.International journal of molecular and cellular medicine · 2024Article
- A Saudi Heart Association Position Statement on Cardiovascular Diseases and Diabetes Mellitus.Journal of the Saudi Heart Association · 2024Article
- Dexamethasone inhibited angiotensin II and its receptors to reduce sepsis-induced lung and kidney injury in rats.PloS one · 2024Article
- Stimulation of angiotensin II type 2 receptor attenuates organ injury in rats with polymicrobial sepsis.Journal of the Chinese Medical Association : JCMA · 2023Article
- Recombinant human angiotensin-converting enzyme 2 plays a protective role in mice with sepsis-induced cardiac dysfunction through multiple signaling pathways dependent on converting angiotensin II to angiotensin 1-7.Annals of translational medicine · 2023Article
- Angiotensin-(1-7) ameliorates sepsis-induced cardiomyopathy by alleviating inflammatory response and mitochondrial damage through the NF-κB and MAPK pathways.Journal of translational medicine · 2023Article
- Renin as a Marker of Tissue Perfusion, Septic Shock and Mortality in Septic Patients: A Prospective Observational Study.International journal of molecular sciences · 2022Observational
- Forebrain control of breathing: Anatomy and potential functions.Frontiers in neurology · 2022Review
- Mechanisms of Post-critical Illness Cardiovascular Disease.Frontiers in cardiovascular medicine · 2022Review
- Plasma Angiotensin II Is Increased in Critical Coronavirus Disease 2019.Frontiers in cardiovascular medicine · 2022Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
introductionMicrovascular dysregulation characterized by hyporesponsive vessels and heterogeneous bloodflow is implicated in the pathogenesis of organ failure in sepsis. The renin-angiotensin system (RAS) affects the microvasculature, yet the relationships between RAS and organ injury in clinical sepsis remain unclear. We tested our hypothesis that systemic RAS mediators are associated with dysregulation of the microvasculature and with organ failure in clinical severe sepsis.
methodsWe studied 30 subjects with severe sepsis, and 10 healthy control subjects. Plasma was analyzed for plasma renin activity (PRA) and angiotensin II concentration (Ang II). Using near-infrared spectroscopy, we measured the rate of increase in the oxygen saturation of thenar microvascular hemoglobin after five minutes of induced forearm ischemia. In so doing, we assessed bulk microvascular hemoglobin influx to the tissue during reactive hyperemia. We studied all subjects 24 hours after the development of organ failure. We studied a subset of 12 subjects at an additional timepoint, eight hours after recognition of organ failure (early sepsis).
resultsAfter 24 hours of resuscitation to clinically-defined endpoints of preload and arterial pressure, Ang II and PRA were elevated in septic subjects and the degree of elevation correlated negatively with the rate of microvascular reoxygenation during reactive hyperemia. Early RAS mediators correlated with microvascular dysfunction. Early Ang II also correlated with the extent of organ failure realized during the first day of sepsis.
conclusionsRAS is activated in clinical severe sepsis. Systemic RAS mediators correlate with measures of microvascular dysregulation and with organ failure.
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