Hyperlactatemia in sepsis and shock: a renal metabolic perspective - PubMed

3 hours ago

Hyperlactatemia in sepsis and shock often occurs without hypoxia, challenging the traditional view of lactate as solely a marker of anaerobic metabolism.
Lactate is a central metabolic intermediate; its levels reflect the balance between production, utilization, and clearance, with the kidneys playing a major role in disposal, especially through proximal tubular cells.
Acute kidney injury (AKI) in sepsis disrupts lactate homeostasis, suggesting that hyperlactatemia should be seen as an integrated metabolic signal of stress and impaired clearance, not just hypoxia.
Urinary lactate may serve as a marker of proximal tubular dysfunction, and protein lactylation could influence the inflammatory-to-reparative transition in septic AKI.

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