Macedo Etienne, Bouchard Josee, Mehta Ravindra L
Division of Nephrology and Hypertension, Department of Medicine, University of California San Diego, San Diego, California, USA.
Curr Opin Crit Care. 2008 Dec;14(6):660-5. doi: 10.1097/MCC.0b013e328317ee6e.
Renal recovery after acute kidney injury (AKI) is an important outcome, most commonly defined as dialysis independence at hospital discharge. This review focuses on the epidemiology of renal recovery after AKI and provides a framework for determining the relationship of a lack of renal recovery and subsequent outcomes including the development of chronic kidney disease.
The majority of studies addressing renal recovery includes only critically ill patients requiring dialysis and considers renal recovery as dialysis independency at hospital discharge. However, a significant proportion of AKI patients are not in the ICU, are not dialyzed, and may require alternate definitions for assessing renal recovery. There is emerging evidence that an AKI episode can lead to chronic kidney disease and can accelerate the progression to end stage renal disease. Patients that survive after AKI present a higher long-term mortality risk, especially those with partial renal recovery.
Patients with incomplete renal recovery after AKI are underrepresented in most epidemiologic studies and the precise effect on the incidence and prevalence of end stage renal disease population has yet to be determined. A standardized definition for renal recovery is needed and the influence of an AKI episode on long-term outcomes needs to be better evaluated.
急性肾损伤（AKI）后的肾功能恢复是一项重要的预后指标，最常见的定义是出院时无需透析。本综述聚焦于AKI后肾功能恢复的流行病学，并提供一个框架，以确定肾功能未恢复与后续预后（包括慢性肾脏病的发生）之间的关系。
大多数关于肾功能恢复的研究仅纳入了需要透析的危重症患者，并将肾功能恢复定义为出院时无需透析。然而，相当一部分AKI患者不在重症监护病房（ICU），未接受透析治疗，可能需要采用其他定义来评估肾功能恢复情况。越来越多的证据表明，一次AKI发作可导致慢性肾脏病，并加速进展至终末期肾病。AKI后存活的患者长期死亡风险更高，尤其是那些肾功能部分恢复的患者。
在大多数流行病学研究中，AKI后肾功能恢复不完全的患者未得到充分体现，其对终末期肾病人群发病率和患病率的精确影响尚待确定。需要一个标准化的肾功能恢复定义，并且需要更好地评估一次AKI发作对长期预后的影响。
