Section of Pulmonary and Critical Care Medicine, Department of Medicine, University of Chicago, Chicago, IL 60637, USA.
Section of Nephrology, Department of Medicine, University of Chicago.
BMJ. 2019 Jan 9;364:k4891. doi: 10.1136/bmj.k4891.
Sepsis is defined as organ dysfunction resulting from the host's deleterious response to infection. One of the most common organs affected is the kidneys, resulting in sepsis associated acute kidney injury (SA-AKI) that contributes to the morbidity and mortality of sepsis. A growing body of knowledge has illuminated the clinical risk factors, pathobiology, response to treatment, and elements of renal recovery that have advanced our ability to prevent, detect, and treat SA-AKI. Despite these advances, SA-AKI remains an important concern and clinical burden, and further study is needed to reduce the acute and chronic consequences. This review summarizes the relevant evidence, with a focus on the risk factors, early recognition and diagnosis, treatment, and long term consequences of SA-AKI. In addition to literature pertaining to SA-AKI specifically, pertinent sepsis and acute kidney injury literature relevant to SA-AKI was included.
脓毒症定义为宿主对感染的有害反应导致的器官功能障碍。受影响最常见的器官之一是肾脏,导致脓毒症相关急性肾损伤(SA-AKI),这是脓毒症发病率和死亡率的原因。越来越多的知识阐明了临床危险因素、病理生理学、对治疗的反应以及肾脏恢复的要素,这些都提高了我们预防、检测和治疗 SA-AKI 的能力。尽管取得了这些进展,但 SA-AKI 仍然是一个重要的关注点和临床负担,需要进一步研究来减轻急性和慢性后果。本综述总结了相关证据,重点关注 SA-AKI 的危险因素、早期识别和诊断、治疗以及长期后果。除了专门针对 SA-AKI 的文献外,还包括与 SA-AKI 相关的脓毒症和急性肾损伤的相关文献。