脓毒症诱导的急性肾损伤
Sepsis-induced acute kidney injury.
作者信息
Majumdar Arghya
机构信息
Department of Nephrology, AMRI Hospitals, Kolkata, India.
出版信息
Indian J Crit Care Med. 2010 Jan;14(1):14-21. doi: 10.4103/0972-5229.63031.
Abstract
Acute kidney injury (AKI) is a common sequel of sepsis in the intensive care unit. It is being suggested that sepsis-induced AKI may have a distinct pathophysiology and identity. Availability of biomarkers now enable us to detect AKI as early as four hours after it's inception and may even help us to delineate sepsis-induced AKI. Protective strategies such as preferential use of vasopressin or prevention of intra-abdominal hypertension may help, in addition to the other global management strategies of sepsis. Pharmacologic interventions have had limited success, may be due to their delayed usage. Newer developments in extracorporeal blood purification techniques may proffer effects beyond simple replacement of renal function, such as metabolic functions of the kidney or modulation of the sepsis cascade.
摘要
急性肾损伤（AKI）是重症监护病房中脓毒症常见的后遗症。有人提出，脓毒症诱导的急性肾损伤可能具有独特的病理生理学特征和特性。生物标志物的可用性现在使我们能够在急性肾损伤开始后四小时就检测到它，甚至可能有助于我们识别脓毒症诱导的急性肾损伤。除了脓毒症的其他整体管理策略外，诸如优先使用血管加压素或预防腹内高压等保护策略可能会有所帮助。药物干预取得的成功有限，这可能是由于其使用延迟。体外血液净化技术的新进展可能会带来超出单纯替代肾功能的效果，例如肾脏的代谢功能或对脓毒症级联反应的调节。
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