Venkataraman Ramesh, Kellum John A
The CRISMA Laboratory, Critical Care Medicine, University of Pittsburgh, 3550 Terrace St, Pittsburgh, PA 15261, USA.
Chest. 2007 Jan;131(1):300-8. doi: 10.1378/chest.06-1246.
Acute renal failure (ARF) comprises a family of syndromes that is characterized by an abrupt and sustained decrease in the glomerular filtration rate. In the ICU, ARF is most often due to sepsis and other systemic inflammatory states. ARF is common among the critically ill and injured and significantly adds to morbidity and mortality of these patients. Despite many advances in medical technology, the mortality and morbidity of ARF in the ICU continue to remain high and have not improved significantly over the past 2 decades. Primary strategies to prevent ARF still include adequate hydration, maintenance of mean arterial pressure, and minimizing nephrotoxin exposure. Diuretics and dopamine have been shown to be ineffective in the prevention of ARF or improving outcomes once ARF occurs. Increasing insight into mechanisms leading to ARF and the importance of facilitating renal recovery has prompted investigators to evaluate the role of newer therapeutic agents in the prevention of ARF.
急性肾衰竭（ARF）是一类综合征，其特征为肾小球滤过率突然且持续下降。在重症监护病房（ICU）中，ARF最常见的病因是脓毒症及其他全身炎症状态。ARF在危重症患者和受伤患者中很常见，显著增加了这些患者的发病率和死亡率。尽管医疗技术取得了许多进展，但ICU中ARF的死亡率和发病率仍然居高不下，在过去20年中并未显著改善。预防ARF的主要策略仍然包括充分补液、维持平均动脉压以及尽量减少肾毒素暴露。利尿剂和多巴胺已被证明在预防ARF或ARF发生后改善预后方面无效。对导致ARF的机制的深入了解以及促进肾脏恢复的重要性，促使研究人员评估新型治疗药物在预防ARF中的作用。
