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We investigated whether inhibiting active sodium transport and oxygen consumption in the medullary thick ascending limb with furosemide attenuates the medullary hypoxia in experimental septic AKI. Sheep were instrumented with flow probes on the pulmonary and renal arteries and fiber optic probes to measure renal cortical and medullary perfusion and oxygen tension (Po<jats:sub>2<\/jats:sub>). Sepsis and AKI were induced by infusion of live Escherichia coli. At 24 h of sepsis there were significant decreases in renal medullary tissue perfusion (1,332\u2009\u00b1\u2009233 to 698\u2009\u00b1\u2009159 blood perfusion units) and Po<jats:sub>2<\/jats:sub> (44\u2009\u00b1\u20096 to 19\u2009\u00b1\u20096 mmHg) (both P &lt; 0.05). By 5 min after intravenous administration of furosemide (20 mg), renal medullary Po<jats:sub>2<\/jats:sub> increased to 43\u2009\u00b1\u20096 mmHg and remained at this normal level for 8 h. Furosemide caused transient increases in fractional excretion of sodium and creatinine clearance, but medullary perfusion, renal blood flow, and renal oxygen delivery were unchanged. Urinary F<jats:sub>2<\/jats:sub>-isoprostanes, an index of oxidative stress, were not significantly changed at 24 h of sepsis but tended to transiently decrease after furosemide treatment. In septic AKI, furosemide rapidly restored medullary Po<jats:sub>2<\/jats:sub> to preseptic levels. This effect was not accompanied by changes in medullary perfusion or renal oxygen delivery but was accompanied by a transient increase in fractional sodium excretion, implying decreased oxygen consumption as a mechanism. <\/jats:p>","DOI":"10.1152\/ajpregu.00371.2018","type":"journal-article","created":{"date-parts":[[2019,5,29]],"date-time":"2019-05-29T14:36:22Z","timestamp":1559140582000},"page":"R232-R239","source":"Crossref","is-referenced-by-count":24,"title":["Furosemide reverses medullary tissue hypoxia in ovine septic acute kidney injury"],"prefix":"10.1152","volume":"317","author":[{"given":"Naoya","family":"Iguchi","sequence":"first","affiliation":[{"name":"Pre-Clinical Critical Care Unit, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia"},{"name":"Department of Intensive Care, Austin Hospital, Melbourne, Australia"},{"name":"Department of Anesthesiology and Intensive Care Medicine, Graduate School of Medicine, Osaka 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