Medical Intensive Care Unit, Saint-Louis University Hospital, AP-HP, Paris, France; Faculté de Médecine, Université Paris-Diderot, Sorbonne-Paris-Cité, Paris, France; ECSTRA Team (Epidémiologie Clinique et Statistiques pour la Recherche en sAnté), Biostatistics and Clinical Epidemiology, UMR 1153, Center of Epidemiology and Biostatistic Sorbonne Paris Cité, INSERM, Paris, France.
Medical Intensive Care Unit, Grenoble University Hospital, La Tronche, France.
Semin Nephrol. 2019 Sep;39(5):431-441. doi: 10.1016/j.semnephrol.2019.06.003.
Despite the vast amount of literature dedicated to acute kidney injury (AKI) and its clinical consequences, short-term renal recovery has been relatively neglected. Recent studies have suggested that timing of renal recovery is associated with longer-term risk of death, residual renal function, and end-stage renal failure risk. In addition, longer AKI duration is associated with an increased requirement for renal replacement therapy. Comorbidities, especially renal and cardiovascular, severity of AKI, criteria to reach AKI diagnosis, as well as severity of critical illness have been associated with longer AKI duration, and, more specifically, risk of persistent renal dysfunction. Because predicting short-term renal recovery is clinically relevant, several tests, imaging, and biomarkers have been tested in a way to predict the course of AKI and chances for early renal recovery. In this review, the definition of recovery, consequences of persistent AKI, and tools proposed to predict recovery are described. The performance of these tools and their limits are discussed.
尽管有大量文献致力于急性肾损伤 (AKI) 及其临床后果，但短期肾功能恢复相对被忽视。最近的研究表明，肾功能恢复的时间与长期死亡风险、残余肾功能和终末期肾衰竭风险相关。此外，AKI 持续时间较长与肾脏替代治疗的需求增加有关。合并症，特别是肾脏和心血管疾病、AKI 的严重程度、达到 AKI 诊断的标准以及危重病的严重程度与 AKI 持续时间较长有关，更具体地说，与持续性肾功能障碍的风险相关。由于预测短期肾功能恢复具有临床相关性，因此已经有几种测试、影像学和生物标志物被用于预测 AKI 的病程和早期肾功能恢复的机会。在这篇综述中，描述了恢复的定义、持续性 AKI 的后果以及用于预测恢复的工具。讨论了这些工具的性能及其局限性。
