Critical Care, St George's, University of London, London, UK.
Nephrol Dial Transplant. 2013 Jul;28(7):1634-47. doi: 10.1093/ndt/gft091. Epub 2013 May 17.
The concept of hepatorenal syndrome is well recognized, although incompletely understood. The converse clinical problem of hepatic dysfunction in patients with acute kidney injury (AKI) is less well recognized yet may be a contributor to the high patient morbidity and mortality seen in this group. This review draws together the available evidence for AKI's effect on the liver from animal models, pharmacological studies and recent clinical data. It examines liver function beyond clinically used blood tests, to determine the effect of AKI on hepatic synthetic function, acute phase response and drug metabolism. Parallels are drawn with other organ crosstalk in AKI and with liver-kidney interactions in chronic kidney disease. Definition of the pathophysiology of renohepatic crosstalk may lead to improved management strategies for this vulnerable patient group.
肝肾功能综合征的概念已得到广泛认可，尽管其机制尚未完全阐明。相反，急性肾损伤（AKI）患者肝功能障碍的临床问题尚未得到充分认识，但可能是导致该组患者高发病率和死亡率的原因之一。本综述汇集了来自动物模型、药理学研究和最近临床数据的关于 AKI 对肝脏影响的现有证据。它检查了肝功能超出临床常用血液检查的范围，以确定 AKI 对肝脏合成功能、急性期反应和药物代谢的影响。并与 AKI 中其他器官的相互作用以及慢性肾脏病中的肝肾相互作用进行了比较。对肾肝相互作用的病理生理学的定义可能会为这一脆弱患者群体的治疗提供更好的管理策略。
