Department of Nephrology, St. Bortolo Hospital, Vicenza, Italy,
Curr Infect Dis Rep. 2012 Oct;14(5):462-73. doi: 10.1007/s11908-012-0274-4.
Acute kidney injury (AKI) often complicates sepsis, leading to greater complexity and a worsening prognosis. Advances in the clinical management of sepsis may have secondary benefits with respect to renal outcomes. In critically ill patients, this disorder typically produces multiple organ dysfunction. Among the several disorders encountered in sepsis, AKI is one of the most important because it is a life-threatening condition, increases the complexity and cost of care, and is an independent risk factor for mortality. The potential interventions in sepsis-related AKI consist of effective prevention/protection strategies for the kidney in patients at risk, early recognition and attenuation of renal damage, pathophysiology-driven pharmacologic support, efficient extracorporeal blood purification therapy, and strategies that promote recovery of renal function. Existing and hybrid extracorporeal therapies are being investigated not only as means to replace lost kidney function, but also to modulate the immune response to sepsis.
急性肾损伤（AKI）常并发于脓毒症，使病情更为复杂，预后更差。脓毒症临床治疗的进展可能对肾脏结局有次要的益处。在危重症患者中，这种疾病通常会导致多器官功能障碍。在脓毒症中遇到的几种疾病中，AKI 是最重要的一种，因为它是一种危及生命的病症，增加了护理的复杂性和成本，并且是死亡率的独立危险因素。脓毒症相关 AKI 的潜在干预措施包括对有风险的患者进行有效的肾脏预防/保护策略、早期识别和减轻肾损伤、基于病理生理学的药物支持、高效的体外血液净化治疗，以及促进肾功能恢复的策略。现有的和混合的体外治疗方法不仅被研究用于替代丧失的肾功能，而且还被用于调节对脓毒症的免疫反应。
