急性肾损伤:流行病学、预后、并发症及治疗策略。

Acute kidney injury: Epidemiology, outcomes, complications, and therapeutic strategies.

作者信息

Negi Shigeo, Koreeda Daisuke, Kobayashi Sou, Yano Takuro, Tatsuta Koichi, Mima Toru, Shigematsu Takashi, Ohya Masaki

机构信息

Department of Nephrology, Wakayama Medical University, Wakayama, Japan.

出版信息

Semin Dial. 2018 Sep;31(5):519-527. doi: 10.1111/sdi.12705. Epub 2018 May 8.

Abstract

Acute kidney injury (AKI) is one of the most common serious complications for all hospital admissions, with its incidence increasing among hospitalized patients, particularly those in the intensive care unit. Despite significant improvements in critical care and dialysis technology, AKI is associated with an increased risk of short- and long-term mortality, prolonged hospital stays, and dialysis dependence. These risks are particularly relevant for critically ill patients with AKI severe enough to require renal replacement therapy (RRT). No specific pharmacologic treatment has been established to treat AKI. Hence, the mainstay treatment for patients with AKI is RRT even though there are still several problematic issues regarding its use including RRT modality, dose, and timing. Recently, the impact of AKI on an increased risk of progression to chronic kidney disease (CKD) and end-stage renal disease requiring dialysis or transplantation is attracting increased attention.

摘要

急性肾损伤(AKI)是所有住院患者中最常见的严重并发症之一,其在住院患者中的发病率不断上升,尤其是在重症监护病房的患者。尽管重症监护和透析技术有了显著进步,但AKI仍与短期和长期死亡风险增加、住院时间延长以及透析依赖有关。这些风险对于病情严重到需要肾脏替代治疗(RRT)的AKI重症患者尤为相关。目前尚未确立治疗AKI的特异性药物治疗方法。因此,AKI患者的主要治疗方法是RRT,尽管在其使用方面仍存在一些问题,包括RRT模式、剂量和时机。最近,AKI对进展为慢性肾脏病(CKD)以及需要透析或移植的终末期肾病风险增加的影响正受到越来越多的关注。

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