Featured Articles: Monthly Infographic

Nathan, Naveen MD

Author Information

Attribution: The Infographic is composed by Naveen Nathan MD.

The author declares no conflict of interest.

Anesthesia & Analgesia | DOI: 10.1213/ANE.0000000000006965 Metrics

The renin-angiotensin axis plays a critical role in the maintenance of systemic perfusion and fluid balance. Renin release is triggered by systemic hypoperfusion, hypovolemia, activation of the sympathetic nervous system, reduced angiotensin II, and decreased sodium concentration at the juxtaglomerular apparatus in the nephrons. As such it may serve as a marker in critical illness states that result in reduced effective systemic perfusion. Authors in this issue performed a scoping review to explore the role of renin as a prognostic marker for morbidity in critically ill and perioperative patients. One thousand, five hundred and seventy three patients across sixteen studies were identified. As summarized in this infographic, studies found an association between renin levels and poor outcomes and mortality. Their review also identified renin levels as a potential indication for the use of angiotensin II to manage critical illness. Lastly, renin was found to be potentially superior to lactate in predicting mortality. A visual summary of their review is presented in this infographic, though the reader is strongly encouraged to review the cited article for a more thorough understanding of the illustrated concepts.

1. Kotani Y, et al. Renin as a prognostic marker in intensive care and perioperative settings: a scoping review. Anesth Analg. 2024;138:929–36. Copyright © 2024 International Anesthesia Research Society