What happens to the kidneys during sepsis?

Acute kidney injury (AKI) is far more dangerous and complex than previously understood. In this episode, host Nicole Kupchik sits down with Dr. Gonzalo Matzumura to break down what really happens inside the kidneys during sepsis. From disrupted renal perfusion, tubular cell injury, and overwhelming inflammation, clinicians and, more importantly, patients, face high stakes when it comes to treating sepsis-related AKI. Dr. Matzumura sheds light on why prevention, recognition, and calling in the nephrologist earlier can mean the difference between lifelong disease, kidney replacement therapy, and full recovery. We’re also joined by Josh and Chelsea Woodward who share their powerful sepsis survival story, recounting how just a few red spots on Josh’s skin quickly spiraled into a medical crisis, underscoring just how quickly AKI and sepsis can escalate and why awareness is essential. Featured Guests: Gonzalo Matzumura Umemoto, MD,(@GMatzumura) is an Assistant Professor of Medicine in the Division of Nephrology at Washington University School of Medicine. He serves as the Director of Acute Dialysis Services at Barnes-Jewish Hospital. Key Takeaways: Nearly 45-70% of acute kidney injuries in the ICU are linked to sepsis, making early recognition critical for improving survival. Kidney-toxic medications used during sepsis treatment (vancomycin, gentamicin, amphotericin, vasopressors) can worsen AKI, requiring careful dosing and monitoring. Creatinine levels lag 24-48 hours, meaning kidney injury is often detected too late; clinicians need better biomarkers and early monitoring. Fluid resuscitation requires balance. Overload can precipitate the need for kidney replacement therapy, especially in oliguric patients. Sepsis-related AKI is multifactorial, involving inflammation, immune activation, microcirculatory dysfunction, and in some cases, mitochondrial injury. — Get in Touch: info@sepsis.org Or Visit Us At: SepsisPodcast.org Connect with Nicole on Socials: @nicolekupchik Connect with Sepsis Alliance on Socials: @sepsisalliance To Learn More About Sepsis, Visit Sepsis.org Produced by: Human Content and Sepsis Alliance Sepsis is a life-threatening emergency that happens when your body’s response to an infection damages vital organs and, often, causes death. In other words, it’s your body’s overactive and toxic response to an infection. Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment. Sepsis can lead to severe sepsis and septic shock. Sepsis Alliance is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.