Division of Cardiology, Department of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, Texas.
Division of Nephrology, Department of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, Texas.
Catheter Cardiovasc Interv. 2021 Jul 1;98(1):E91-E105. doi: 10.1002/ccd.29141. Epub 2020 Jul 29.
Acute kidney injury (AKI) is an ominous predictor of mortality in cardiogenic shock. The present review examines the pathophysiology of AKI in cardiogenic shock (CS), summarizes the pertinent literature including the diagnostic criteria/definitions for AKI and possible role of biomarkers, and identifies risk factors and possible therapeutic interventions for AKI in CS. Our review finds that AKI is common in patients with CS and is associated with increased morbidity and mortality. Urinary biomarkers of renal tubular injury appear more sensitive for detection of AKI but have yet to be incorporated into daily practice. Emerging data would suggest vasopressor choices, mechanical circulatory support, and renal replacement therapy may have important therapeutic roles in the management of CS.
急性肾损伤（AKI）是心源性休克患者死亡率的一个凶险预测因素。本综述探讨了心源性休克（CS）中 AKI 的病理生理学，总结了相关文献，包括 AKI 的诊断标准/定义和生物标志物的可能作用，并确定了 CS 中 AKI 的危险因素和可能的治疗干预措施。我们的综述发现，AKI 在 CS 患者中很常见，并且与发病率和死亡率的增加有关。尿肾小管损伤的生物标志物似乎对 AKI 的检测更敏感，但尚未纳入日常实践中。新出现的数据表明，血管加压药的选择、机械循环支持和肾脏替代治疗在 CS 的治疗中可能具有重要的治疗作用。
