Villa Gianluca, Ricci Zaccaria, Ronco Claudio
Section of Anaesthesiology and Intensive Care, Department of Health Science, University of Florence, Florence, Italy.
Pediatric Cardiac Intensive Care Unit, Department of Cardiology and Cardiac Surgery, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, CAP 00165, Rome, Italy.
Crit Care Clin. 2015 Oct;31(4):839-48. doi: 10.1016/j.ccc.2015.06.015. Epub 2015 Jul 29.
Renal replacement therapy (RRT) is a cornerstone in the clinical management of patients with acute kidney injury. Results from different studies agree that early renal support therapy (aimed to support the residual kidney function during early phases of organ dysfunction) may reduce mortality with respect to late RRT (aimed to substitute the complete loss of function during the advanced kidney insufficiency). Although it seems plausible that a timely initiation of RRT may be associated with improved renal and nonrenal outcomes in these patients, there is scarce evidence in literature to exactly identify the most adequate onset timing for RRT.
肾脏替代疗法(RRT)是急性肾损伤患者临床管理的基石。不同研究的结果一致表明,早期肾脏支持治疗(旨在在器官功能障碍的早期阶段支持残余肾功能)相对于晚期RRT(旨在替代晚期肾功能不全时完全丧失的功能)可能降低死亡率。虽然及时开始RRT可能与这些患者改善肾脏和非肾脏结局相关这一点似乎合理,但文献中几乎没有证据能确切确定RRT最恰当的开始时机。