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[急性肾损伤]

[Acute kidney injury].

作者信息

Hageman David, Kooman Jeroen P, Lancé Marcus D, van Heurn L W Ernst, Snoeijs Maarten G J

机构信息

MUMC, Afd. Heelkunde, Maastricht, the Netherlands.

出版信息

Ned Tijdschr Geneeskd. 2012;156(50):A5057.

Abstract

'Acute kidney injury' is modern terminology for a sudden decline in kidney function, and is defined by the RIFLE classification (RIFLE is an acronym for Risk, Injury, Failure, Loss and End-stage kidney disease). Acute kidney injury occurs as a result of the combination of reduced perfusion in the kidney, systemic inflammation, and the administration of nephrotoxic drugs. Patients with chronic renal damage, advanced age, diabetes mellitus or heart failure are at an increased risk of acute kidney injury. In the short term, acute kidney injury leads to a markedly increased risk of death; the long-term effect of acute kidney injury is a permanent loss of renal microcirculation which could result in chronic renal disease. Certain biomarkers in the urine offer new possibilities for detecting acute kidney injury in its early stage. Treatment of patients with acute kidney injury is currently supportive in nature. The optimisation of a patient's haemodynamics results in a reduction of the occurrence of acute kidney injury during extensive surgical procedures. A promising treatment aimed at preventing acute kidney injury is called 'remote ischaemic pre-conditioning'.

摘要

“急性肾损伤”是肾功能突然下降的现代术语,由RIFLE分类定义(RIFLE是风险、损伤、衰竭、丧失和终末期肾病的首字母缩写)。急性肾损伤是由于肾脏灌注减少、全身炎症和使用肾毒性药物共同作用所致。患有慢性肾损伤、高龄、糖尿病或心力衰竭的患者发生急性肾损伤的风险增加。短期内,急性肾损伤会导致死亡风险显著增加;急性肾损伤的长期影响是肾微循环永久性丧失,这可能导致慢性肾病。尿液中的某些生物标志物为早期检测急性肾损伤提供了新的可能性。目前,急性肾损伤患者的治疗本质上是支持性的。优化患者的血流动力学可减少大型外科手术期间急性肾损伤的发生。一种有前景的预防急性肾损伤的治疗方法称为“远程缺血预处理”。

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