Dirkes Susan
Surgical ICU, University of Michigan Health System, Newport, MI, USA.
Nephrol Nurs J. 2013 Mar-Apr;40(2):125-32; quiz 133.
Acute kidney injury (AKI), or acute renal failure, is associated with hospital stays, increased economic costs, and significant mortality, particularly in the context of critically ill patients in the intensive care setting. Numerous factors contribute to the development of AKI, including reductions in renal blood flow, actions of nephrotoxic drugs, cellular injury or death of proximal tubular cells, and the proinflammatory responses of renal cells. Sepsis and septic shock are the dominant causes of AKI due to impairments in the microcirculation. Dysfunction of the microcirculation subsequently causes blood flow disruption and obstruction in the microcirculation, as well as ensuing ischemia. Prompt recognition and treatment of sepsis may decrease the incidence of AKI mortality and its effects on other organ systems.
急性肾损伤（AKI），即急性肾衰竭，与住院时间延长、经济成本增加以及显著的死亡率相关，尤其是在重症监护环境中的危重症患者中。导致急性肾损伤发生的因素众多，包括肾血流量减少、肾毒性药物的作用、近端肾小管细胞的细胞损伤或死亡以及肾细胞的促炎反应。脓毒症和脓毒性休克是急性肾损伤的主要原因，因为它们会导致微循环受损。微循环功能障碍随后会导致微循环中的血流中断和阻塞，以及随之而来的局部缺血。及时识别和治疗脓毒症可能会降低急性肾损伤的死亡率及其对其他器官系统的影响。
