Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, 2-124E, Clinical Sciences Building, 8440-112 ST NW, Edmonton, T6G 2B7, Canada.
Service de Reanimation Medicale, Hopital Nord, CHU Saint-Etienne, Ave. Albert Raimond, 42270 Saint-Prient-en-Jarez, EA3065, Saint-Etienne, France.
Intensive Care Med. 2017 Jun;43(6):841-854. doi: 10.1007/s00134-017-4762-8. Epub 2017 Mar 13.
Acute kidney injury (AKI) is associated with incremental risk for death and chronic kidney disease and represents a mounting clinical challenge for healthcare professionals. Renal replacement therapy (RRT) use in ICU settings is rising, likely in response to similar trends in AKI, taken together with an ageing population burdened by high prevalence of multi-morbidity and high illness acuity. Numerous features of RRT prescription and delivery are not standardized, nor are they supported from high-quality evidence derived from randomized trials. Despite the publication of rigorous clinical practice guidelines focused on RRT for AKI that are intended to optimize the quality and reliability of RRT in ICU settings, practice patterns and outcomes continue to show significant variability. In this concise review, we aim to summarize new knowledge and recent advances for the provision of RRT for critically ill patients with AKI.
急性肾损伤 (AKI) 与死亡和慢性肾脏病的风险增加相关，是医疗保健专业人员面临的日益严峻的临床挑战。重症监护病房 (ICU) 中肾脏替代治疗 (RRT) 的使用正在增加，这可能是由于 AKI 的类似趋势，加上人口老龄化，多种疾病的高发和高疾病严重程度。RRT 的处方和提供有许多特征尚未标准化，也没有得到高质量的随机试验证据的支持。尽管发布了针对 AKI 的 RRT 的严格临床实践指南，旨在优化 ICU 环境中 RRT 的质量和可靠性，但实践模式和结果仍显示出显著的变异性。在这篇简明的综述中，我们旨在总结为急性肾损伤的危重患者提供 RRT 的新知识和最新进展。
