Hladunewich M, Rosenthal M H
Stanford University Medical Center, California, USA.
Anesthesiol Clin North Am. 2000 Dec;18(4):773-89. doi: 10.1016/s0889-8537(05)70194-2.
Acute renal failure remains a common, devastating complication of the postoperative period and in the critically ill patient. The most common cause is the progression of prerenal insufficiency to ATN. Despite improved understanding of the pathogenic mechanisms, including impaired hemodynamic autoregulation, medullary hypoxia, and proximal tubular obstruction and transtubular backleak, the treatment, to date, remains largely supportive. Avoidance by ensuring hemodynamic stability, with provision of adequate renal perfusion, provides the best means for minimizing the complications of this organ dysfunction.
急性肾衰竭仍然是术后及重症患者常见且严重的并发症。最常见的病因是肾前性肾功能不全进展为急性肾小管坏死。尽管对其发病机制的认识有所提高，包括血流动力学自身调节受损、髓质缺氧、近端肾小管阻塞及肾小管反流，但迄今为止，治疗仍主要是支持性的。通过确保血流动力学稳定、提供充足的肾脏灌注来避免急性肾衰竭，是将这种器官功能障碍并发症降至最低的最佳方法。
