Doi Kent, Rabb Hamid
Department of Emergency and Critical Care Medicine, The University of Tokyo, Tokyo, Japan.
Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
Kidney Int. 2016 Mar;89(3):555-64. doi: 10.1016/j.kint.2015.11.019. Epub 2016 Jan 16.
Acute kidney injury (AKI) is a common complication in critically ill patients and subsequently worsens outcomes. Although many drugs to prevent and treat AKI have shown benefits in preclinical models, no specific agent has been shown to benefit AKI in humans. Moreover, despite remarkable advances in dialysis techniques that enable management of AKI in hemodynamically unstable patients with shock, dialysis-requiring severe AKI is still associated with an unacceptably high mortality rate. Thus, focusing only on kidney damage and loss of renal function has not been sufficient to improve outcomes of patients with AKI. Recent data from basic and clinical research have begun to elucidate complex organ interactions in AKI between kidney and distant organs, including heart, lung, spleen, brain, liver, and gut. This review serves to update the topic of organ cross talk in AKI and focuses on potential therapeutic targets to improve patient outcomes during AKI-associated multiple organ failure.
急性肾损伤（AKI）是危重症患者常见的并发症，会使预后恶化。尽管许多预防和治疗AKI的药物在临床前模型中显示出益处，但尚无特定药物在人类AKI中显示出有益效果。此外，尽管透析技术取得了显著进展，能够对休克血流动力学不稳定的患者进行AKI管理，但需要透析的严重AKI仍与高得难以接受的死亡率相关。因此，仅关注肾脏损伤和肾功能丧失不足以改善AKI患者的预后。基础和临床研究的最新数据已开始阐明AKI中肾脏与包括心脏、肺、脾脏、大脑、肝脏和肠道在内的远处器官之间复杂的器官相互作用。本综述旨在更新AKI中器官相互作用的主题，并关注在AKI相关多器官功能衰竭期间改善患者预后的潜在治疗靶点。
