Histopathology of Septic Acute Kidney Injury: A Systematic Review of Experimental Data.

Objective: The histopathologic changes associated with septic acute kidney injury are poorly understood, in part, because of the lack of biopsy data in humans. Animal models of septic acute kidney injury may help define such changes. Therefore, we performed a systematic review of the histopathologic changes found in modern experimental septic acute kidney injury models. Data Sources: MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, and PubMed (from January 2007 to February 2015). Study Selection: We reviewed experimental studies reporting findings on the histopathology of contemporary experimental septic acute kidney injury. Data Extraction: We focused on the presence or the absence of acute tubular necrosis, tubular cell apoptosis, and other nonspecific findings. Data Synthesis: We identified 102 studies in 1,059 animals. Among the 1,059 animals, 53 (5.0%) did not have any renal histopathologic changes, but acute tubular necrosis was found in 184 (17.4%). The prevalence of acute tubular necrosis was not related to animal size or model of sepsis and was only found in models with low cardiac output and decreased renal blood flow (p

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