Jones Dean R, Lee H Thomas
Department of Anesthesiology, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA.
Best Pract Res Clin Anaesthesiol. 2008 Mar;22(1):193-208. doi: 10.1016/j.bpa.2007.08.005.
Acute kidney injury (AKI) is a significant cause of perioperative patient morbidity and mortality. The definition of AKI has recently changed and further research is underway to identify clinically relevant biomarkers to aid in the diagnosis of the syndrome. AKI is often multi-factorial in origin and patients with certain preoperative risk factors are at elevated risk of perioperative AKI. An anesthesiologist's main objective for perioperative renal protection is prevention by maintenance of euvolemia, preservation of adequate renal perfusion, and avoidance of nephrotoxins. This review will address the definition and diagnosis of AKI, identify patients at risk of AKI, and critically appraise management options for perioperative renal protection.
急性肾损伤（AKI）是围手术期患者发病和死亡的重要原因。AKI的定义最近发生了变化，目前正在进行进一步研究，以确定有助于该综合征诊断的临床相关生物标志物。AKI通常起源于多因素，具有某些术前危险因素的患者围手术期发生AKI的风险较高。麻醉医生围手术期肾脏保护的主要目标是通过维持血容量正常、保持充足的肾脏灌注和避免肾毒素来预防。本综述将阐述AKI的定义和诊断，识别有AKI风险的患者，并严格评估围手术期肾脏保护的管理方案。
