Goldstein Stuart L, Chawla Lakhmir, Ronco Claudio, Kellum John A
Crit Care. 2014 Jan 6;18(1):301. doi: 10.1186/cc13180.
Acute kidney injury (AKI) research in the past decade has mostly focused upon development of a standard AKI definition, validation of early novel biomarkers to predict AKI prior to serum creatinine rise and predict AKI severity, and assessment of aspects of renal replacement therapies and their impact on survival. Given the independent association between AKI and mortality in the acute phase, such focus makes imminent sense. More recently, the recognition that AKI is associated with subsequent development of chronic kidney disease and end-stage renal disease, with the attendant increase in mortality, has led to interest in the clinical epidemiology and the mechanistic understanding of renal recovery after an AKI episode in critically ill patients. We review the current knowledge surrounding renal recovery after an AKI episode, including renal replacement therapy initiation timing and modality impact, biomarker assessment and mechanistic targets to guide potential future clinical trials.
在过去十年中，急性肾损伤（AKI）的研究主要集中在制定标准的AKI定义、验证在血清肌酐升高之前预测AKI及预测AKI严重程度的新型早期生物标志物，以及评估肾脏替代治疗的各个方面及其对生存率的影响。鉴于AKI与急性期死亡率之间存在独立关联，这种关注具有迫切的意义。最近，人们认识到AKI与随后慢性肾脏病和终末期肾病的发生相关，随之而来的是死亡率增加，这引发了对危重症患者AKI发作后肾脏恢复的临床流行病学和机制理解的兴趣。我们综述了目前关于AKI发作后肾脏恢复的知识，包括肾脏替代治疗开始时机和方式的影响、生物标志物评估以及指导未来潜在临床试验的机制靶点。
