Carmichael Paul, Carmichael Amtul R
Kent and Canterbury Hospital, Canterbury, Renal Medicine, Canterbury, Kent, United Kingdom.
ANZ J Surg. 2003 Mar;73(3):144-53. doi: 10.1046/j.1445-2197.2003.02640.x.
Acute renal failure (ARF) is an unwelcome complication of major surgical procedures that contributes to surgical morbidity and mortality. Acute renal failure associated with surgery may account for 18-47% of all cases of hospital-acquired ARF. The overall incidence of ARF in surgical patients has been estimated at 1.2%, although is higher in at-risk groups. Mortality of patients with ARF remains disturbingly high, ranging from 25% to 90%, despite advances in dialysis and intensive care support. Appreciation of at-risk surgical populations coupled with intensive perioperative care has the capacity to reduce the incidence of ARF and by implication mortality. Developments in understanding the pathophysiology of ARF may eventually result in newer therapeutic strategies to either prevent or accelerate recovery from ARF. At present the best form of treatment is prevention. In this review the epidemiology, pathophysiology, diagnosis, treatment and possible prevention of ARF will be discussed.
急性肾衰竭（ARF）是大型外科手术中一种不良并发症，会增加手术的发病率和死亡率。与手术相关的急性肾衰竭可能占所有医院获得性ARF病例的18% - 47%。外科患者中ARF的总体发病率估计为1.2%，尽管在高危人群中更高。尽管透析和重症监护支持有所进步，但ARF患者的死亡率仍然高得惊人，在25%至90%之间。识别高危手术人群并加强围手术期护理有能力降低ARF的发病率，进而降低死亡率。对ARF病理生理学认识的进展最终可能会产生更新的治疗策略，以预防ARF或加速其恢复。目前，最佳的治疗方式是预防。在本综述中，将讨论ARF的流行病学、病理生理学、诊断、治疗及可能的预防措施。
