Laake Jon Henrik, Bugge Jan Fredrik
Anestesi- og intensivklinikken, Oslo universitetssykehus, Rikshospitalet, 0027 Oslo, Norway.
Tidsskr Nor Laegeforen. 2010 Jan 28;130(2):158-61. doi: 10.4045/tidsskr.10.34549.
Acute renal failure is common in critically ill patients and is associated with a high mortality rate. This paper reviews current management of patients with acute renal failure admitted to an intensive care unit.
Literature search in databases (Medline, Cochrane database of systematic reviews, UpToDate).
The prevalence of acute renal failure is 5-20 % in patients admitted to intensive care units; the associated hospital mortality is 30-60 %. The aetiology is usually multifactorial; inflammation (sepsis, surgery), hypovolaemia and drug toxicity commonly precipitate acute renal failure. There is no effective drug treatment, but early onset of renal replacement therapies with haemodialysis or haemofiltration is likely to prolong survival.
Despite modern intensive care, mortality is high in acute renal failure and preventive measures should therefore be vigorously pursued. Haemodialysis and haemofiltration should be introduced early in acute renal failure, and should be available in all intensive care units.
急性肾衰竭在危重症患者中很常见，且死亡率很高。本文综述了入住重症监护病房的急性肾衰竭患者的当前治疗方法。
在数据库（医学文献数据库、Cochrane系统评价数据库、UpToDate）中进行文献检索。
入住重症监护病房的患者中急性肾衰竭的患病率为5% - 20%；相关的医院死亡率为30% - 60%。病因通常是多因素的；炎症（脓毒症、手术）、血容量不足和药物毒性常促使急性肾衰竭的发生。没有有效的药物治疗方法，但早期开始进行血液透析或血液滤过的肾脏替代治疗可能会延长生存期。
尽管有现代重症监护治疗，但急性肾衰竭的死亡率仍然很高，因此应大力采取预防措施。血液透析和血液滤过应在急性肾衰竭早期进行，并且所有重症监护病房都应具备这些治疗手段。
