Hishida A, Kato A
Rinsho Byori. 1992 Oct;40(10):1048-53.
This review is focused on the roles of laboratory test in acute renal failure (ARF). The roles of the laboratory test changes along with the alterations in clinical features and with the advances of treatment. Recent acute renal failure is characterized by the following three features: most of the ARF develops in hospitals, the frequency of nonoliguric ARF is increasing, and the association of other organ failure such as heart failure, liver failure or respiratory failure, increases the mortality rate. Hemodialysis is instituted in the early phase of ARF to enable the supply of enough nutriments and drugs. These features of recent ARF increases the importance of the frequent analysis of plasma creatinine in patients, who are at risk for ARF, to diagnose ARF at the onset. After the development of ARF, laboratory tests for the evaluation of other organ function is repeated. The development of new drugs increases the incidence of interstitial nephritis, and the advances in the therapeutic approach on systemic diseases (such as SLE or PN), which frequently develop ARF, alter the prognosis of these diseases. Since the early diagnosis of these diseases is important, it is necessary to develop noninvasive and reliable tests for the diagnosis of these diseases.
本综述聚焦于实验室检查在急性肾衰竭（ARF）中的作用。实验室检查的作用随着临床特征的改变以及治疗进展而变化。近期急性肾衰竭具有以下三个特点：大多数ARF在医院发生，非少尿型ARF的发生率在增加，并且诸如心力衰竭、肝衰竭或呼吸衰竭等其他器官衰竭的合并存在增加了死亡率。在ARF早期进行血液透析，以便能够提供足够的营养物质和药物。近期ARF的这些特点增加了对有ARF风险患者频繁分析血浆肌酐以在发病时诊断ARF的重要性。在ARF发生后，重复进行评估其他器官功能的实验室检查。新药的研发增加了间质性肾炎的发生率，而对经常发生ARF的全身性疾病（如系统性红斑狼疮或多发性神经炎）治疗方法的进展改变了这些疾病的预后。由于这些疾病的早期诊断很重要，因此有必要研发用于诊断这些疾病的无创且可靠的检查。
