Effects of Ischemic Acute Kidney Injury on Lung Water Balance: Nephrogenic Pulmonary Edema?

Figure 1

Nephrogenic pulmonary edema. Acute kidney injury triggers numerous mechanisms which alter the homeostasis of pulmonary interstitial and alveolar fluid balance. 𝑄_𝑓: net flow across the alveolar-capillary membrane; 𝐾_𝑓: filtration coefficient; 𝑃_𝐶: capillary hydrostatic pressure; 𝑃_𝑇: interstitial fluid hydrostatic pressure; 𝜎: reflection coefficient of the alveolar-capillary membrane; 𝜋_𝐶: capillary oncotic pressure; 𝜋_𝑇: interstitial oncotic pressure; NOS: nitric oxide synthase; HO-1: heme-oxygenase-1; Lcn-2: lipocalin-2; CXCL-2: chemokine ligand-2; IL-6: interleukin-6; TNF-α: tumor necrosis factor-α; Na/K-ATPase: sodium-potassium ATPase; ENaC: endothelial sodium channel. It is important to note that negative changes in the reflection coefficient likely also increase the filtration coefficient leading to a net increase in fluid flow across the alveolar-capillary membrane.