From Tufts Medical Center, Boston, Massachusetts, and the University of Calgary, Calgary, Alberta.
Ann Intern Med. 2017 Nov 7;167(9):ITC66-ITC80. doi: 10.7326/AITC201711070.
Acute kidney injury is a heterogeneous group of conditions characterized by a sudden decrease in glomerular filtration rate, manifested by an increase in serum creatinine concentration or oliguria, and classified by stage and cause. This type of injury occurs in approximately 20% of hospitalized patients, with major complications including volume overload, electrolyte disorders, uremic complications, and drug toxicity. Management includes specific treatments according to the underlying cause and supportive treatment to prevent and manage complications. Kidney replacement therapy is used when complications cannot be managed with medical therapy alone. Despite advances in care, the mortality rate in patients requiring kidney replacement therapy remains approximately 50%.
急性肾损伤是一组以肾小球滤过率突然下降为特征的异质性疾病,表现为血清肌酐浓度升高或少尿,并按阶段和病因进行分类。这种损伤在大约 20%的住院患者中发生,主要并发症包括容量超负荷、电解质紊乱、尿毒症并发症和药物毒性。治疗包括根据潜在原因进行特定治疗和支持性治疗以预防和管理并发症。当并发症不能仅通过药物治疗来管理时,使用肾脏替代疗法。尽管在治疗方面取得了进展,但需要肾脏替代治疗的患者的死亡率仍约为 50%。