Khajuria Ankur, Tay Charison, Shi Jiaqi, Zhao Hailin, Ma Daqing
Anaesthetics, Pain Medicine, and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea and Westminster Campus, 369 Fulham Road, London SW10 9NH, UK.
Anaesthetics, Pain Medicine, and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea and Westminster Campus, 369 Fulham Road, London SW10 9NH, UK.
Acta Anaesthesiol Taiwan. 2014 Dec;52(4):176-84. doi: 10.1016/j.aat.2014.10.001. Epub 2014 Dec 1.
Acute kidney injury (AKI) secondary to ischemia-reperfusion injury (IRI) is a major cause of patient morbidity and mortality in the perioperative period. It can lead to new onset of chronic kidney disease and accelerate its progression. Patients with risk factors undergoing cardiac, vascular, and liver transplantation surgeries, which may inevitably involve IRI, are more susceptible to AKI. Anesthetic agents have been postulated to possess renoprotective properties. Thus, exploring the utilization of selective perioperative anesthetic agents with renoprotective properties may be a promising avenue to reduce the risk of AKI. This review discusses the effects and mechanisms of dexmedetomidine, inhalational and intravenous anesthetics, and xenon-mediated renoprotection. Although the renoprotective effects of these agents obtained in the laboratory are promising, much work especially via clinical trials is required to determine the translational value from the bench to the bedside.
缺血再灌注损伤（IRI）继发的急性肾损伤（AKI）是围手术期患者发病和死亡的主要原因。它可导致慢性肾脏病的新发并加速其进展。接受心脏、血管和肝移植手术且伴有风险因素的患者，手术过程中不可避免地会涉及IRI，因而更易发生AKI。有研究推测麻醉药物具有肾脏保护特性。因此，探索具有肾脏保护特性的选择性围手术期麻醉药物的应用，可能是降低AKI风险的一条有前景的途径。本文综述了右美托咪定、吸入性和静脉麻醉药以及氙气介导的肾脏保护作用及其机制。尽管这些药物在实验室中获得的肾脏保护作用很有前景，但仍需要开展大量工作，尤其是通过临床试验来确定从实验室到临床应用的转化价值。
