St George's Hospital, London, SW17 0QT, UK.
Dept of Anesthesiology and Critical Care Medicine, Duke University Medical Center/Durham VAMC, Durham, USA.
Perioper Med (Lond). 2012 Jul 4;1:6. doi: 10.1186/2047-0525-1-6. eCollection 2012.
Acute kidney injury (AKI) is a serious complication in the perioperative period, and is consistently associated with increased rates of mortality and morbidity. Two major consensus definitions have been developed in the last decade that allow for easier comparison of trial evidence. Risk factors have been identified in both cardiac and general surgery and there is an evolving role for novel biomarkers. Despite this, there has been no real change in outcomes and the mainstay of treatment remains preventive with no clear evidence supporting any therapeutic intervention as yet. This review focuses on definition, risk factors, the emerging role of biomarkers and subsequent management of AKI in the perioperative period, taking into account new and emerging strategies.
急性肾损伤(AKI)是围手术期的一种严重并发症,始终与更高的死亡率和发病率相关。在过去十年中已经制定了两个主要的共识定义,这使得试验证据的比较更加容易。已经在心脏和普通外科手术中确定了危险因素,并且新型生物标志物的作用也在不断发展。尽管如此,结果并没有真正改变,治疗的主要方法仍然是预防,目前尚无明确证据支持任何治疗干预。本综述重点关注围手术期 AKI 的定义、危险因素、新兴生物标志物的作用以及随后的管理,同时考虑了新出现的策略。