Department of Critical Care & Nephrology, King's College London, Guy's & St Thomas' Hospital, London, SE1 7EH, UK.
Division of Nephrology and Critical Care, Department of Medicine, University of California, San Francisco, CA, USA.
Best Pract Res Clin Anaesthesiol. 2017 Sep;31(3):305-314. doi: 10.1016/j.bpa.2017.09.001. Epub 2017 Sep 22.
Acute kidney injury (AKI) is common in the perioperative and intensive care setting. Although AKI is usually multifactorial, haemodynamic instability, sepsis and drug toxicity are commonly implicated. Independent of the exact aetiology, several different pathophysiologic processes occur simultaneously and in sequence, including endothelial dysfunction, alteration of the microcirculation, tubular injury, venous congestion and intrarenal inflammation. A multitude of different immune cells from within the kidney and the systemic circulation play a role in the development, maintenance and recovery phase of AKI. In this review, we describe the common processes involved in AKI and their connections, with particular emphasis on the perioperative and critical care setting.
急性肾损伤（AKI）在围手术期和重症监护环境中很常见。尽管 AKI 通常是多因素的，但血流动力学不稳定、脓毒症和药物毒性通常与之相关。无论确切的病因如何，几种不同的病理生理过程同时并连续发生，包括内皮功能障碍、微循环改变、肾小管损伤、静脉淤血和肾内炎症。来自肾脏和全身循环的多种不同免疫细胞在 AKI 的发生、维持和恢复阶段发挥作用。在这篇综述中，我们描述了 AKI 涉及的常见过程及其联系，特别强调围手术期和重症监护环境。
