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急性肾损伤的非透析治疗

[Non-dialytic treatment of acute kidney injury].

作者信息

Demiselle Julien, Lerolle Nicolas

机构信息

Département de réanimation médicale et médecine hyperbare, CHU d'Angers, 4, rue Larrey, 49933 Angers, France.

Département de réanimation médicale et médecine hyperbare, CHU d'Angers, 4, rue Larrey, 49933 Angers, France.

出版信息

Nephrol Ther. 2017 Apr;13 Suppl 1:S7-S11. doi: 10.1016/j.nephro.2017.01.009.

Abstract

Acute kidney injury is frequently encountered in patients in intensive care units and is associated with higher risk of mortality and chronic renal failure. Even small increases in serum creatinine are associated with adverse outcomes. Many interventions have been proposed to prevent or treat acute kidney injury in patients in intensive care units. However, no intervention has proved its efficacy in large randomized control trials. This review presents the various attempts aiming at acute kidney injury improvement in patients in intensive care units published over the recent years: hemodynamic interventions, "usual" drugs used in intensive care units, modulation of inflammation and hemostasis, remote ischemic conditioning, drugs specifically dedicated for acute kidney injury, and stimulation of renal recovery.

摘要

急性肾损伤在重症监护病房患者中经常出现,且与更高的死亡率和慢性肾衰竭风险相关。即使血清肌酐水平的小幅升高也与不良结局相关。已经提出了许多干预措施来预防或治疗重症监护病房患者的急性肾损伤。然而,在大型随机对照试验中,没有一种干预措施证明其有效性。本综述介绍了近年来发表的针对改善重症监护病房患者急性肾损伤的各种尝试:血流动力学干预、重症监护病房常用药物、炎症和止血调节、远程缺血预处理、专门用于急性肾损伤的药物以及促进肾脏恢复。

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