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Moreover, HP administration improved animal survival following lethal LPS injections.HP ameliorated apoptosis of tubular cells by inhibiting the cleavage of caspase 3 and caspase 7.Sepsis is a disseminated inflammatory response elicited by a microbial infection (Holthoff et al., 2012) and is the major cause of death among intensive care unit (ICU) patients (Hotchkiss and Karl, 2003; Azevedo, 2013; Alobaidi et al., 2015).Unfortunately, there is no effective treatment for septic patients thus far (O' Neill et al., 2012).The knowledge of the pathophysiology of septic AKI has increased quickly in the past few years, and some traditional theory has been updated.Hemodynamic alteration was considered a major mechanism of AKI, and hypoperfusion was believed to reduce both glomerular filtration and cellular high-energy phosphates, finally producing acute tubular necrosis and apoptosis (Badr et al., 1986; Wan et al., 2008).

Conclusions: HP extract may protect renal function in LPS-induced AKI by anti-inflammatory and antioxidant activities, and has potential in the critical care of AKI.Based on documents of traditional Chinese medicine, many medicinal plants show promising anti-inflammatory and anti-oxidative activities.Hydrangea paniculata Sieb is a medical herb, which is widely distributed in southern of China.Possible molecular mechanisms included HP inhibition of NF-κB nuclear translocation in LPS-induced macrophages and tubular cells, and reduction of STAT3, STAT1, and ERK1/2 phosphorylation stimulated by LPS in vitro.Single acute toxicity tests confirmed that HP, even at 5 g/kg dosage, does not cause animal death.

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