Lameire Norbert, Van Biesen Wim, Vanholder Raymond
Renal Division, Department of Medicine, University Hospital Ghent, De Pintelaan 185, 9000 Ghent, Belgium.
Lancet. 2005;365(9457):417-30. doi: 10.1016/S0140-6736(05)17831-3.
This seminar covers the most recent information on definition, epidemiology, and clinical causes of acute renal failure. The mechanisms of acute prerenal failure and the potential interference by commonly used drugs of autoregulation of renal blood flow are discussed. We summarise some basic and recent insights into the haemodynamic and cellular pathophysiological mechanisms, mainly of postischaemic acute renal failure. Recent findings on the repair mechanisms of renal injury and the potential future therapeutic possibilities are discussed. We provide some differential diagnostic approaches for patients with acute renal failure and summarise prevention of the disorder and management of critically ill patients by dialysis and by other means. Finally, some information on the influence of gene polymorphisms on the prognosis of acute renal failure is given.
本次研讨会涵盖了急性肾衰竭的定义、流行病学及临床病因的最新信息。讨论了急性肾前性肾衰竭的机制以及常用药物对肾血流自动调节的潜在干扰。我们总结了对血流动力学和细胞病理生理机制(主要是缺血后急性肾衰竭)的一些基本及最新见解。讨论了肾损伤修复机制的最新发现以及未来潜在的治疗可能性。我们为急性肾衰竭患者提供了一些鉴别诊断方法,并总结了该病症的预防以及通过透析和其他手段对危重症患者的管理。最后,给出了一些关于基因多态性对急性肾衰竭预后影响的信息。