Marenzi Giancarlo, Cosentino Nicola, Bartorelli Antonio L
Centro Cardiologico Monzino, I.R.C.C.S., University of Milan, Milan, Italy.
Heart. 2015 Nov;101(22):1778-85. doi: 10.1136/heartjnl-2015-307773. Epub 2015 Aug 4.
Acute kidney injury (AKI) is increasingly being seen in patients with acute coronary syndromes (ACSs). This condition has a complex pathogenesis, an incidence that can reach 30% and it is associated with higher short-term and long-term morbidity and mortality. Nevertheless, AKI is still characterised by lack of a single accepted definition, unclear pathophysiology understanding and insensitive diagnostic tools that make its detection difficult, particularly in the setting of ACS. Recent data suggested that patients with AKI during ACS, even those in whom renal function seems to fully recover, face an increased, persisting risk of future AKI and may develop chronic kidney disease. Thus, in these patients, nephrology follow-up, after hospital discharge, and secondary preventive measures should possibly be implemented. In this review, we aim at providing a framework of knowledge to increase cardiologists' awareness of AKI, with the goal of improving the outcome of patients with ACS.
急性肾损伤（AKI）在急性冠状动脉综合征（ACS）患者中越来越常见。这种情况发病机制复杂，发病率可达30%，且与较高的短期和长期发病率及死亡率相关。然而，AKI的特征仍然是缺乏一个被广泛接受的定义、对病理生理学理解不清以及诊断工具不敏感，这使得其检测困难，尤其是在ACS的情况下。最近的数据表明，ACS期间发生AKI的患者，即使那些肾功能似乎已完全恢复的患者，未来发生AKI的风险增加且持续存在，并且可能发展为慢性肾脏病。因此，对于这些患者，出院后可能应进行肾脏病学随访并实施二级预防措施。在本综述中，我们旨在提供一个知识框架，以提高心脏病学家对AKI的认识，从而改善ACS患者的预后。
