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RRT 选择用于伴有危重病的 AKI 患者。

RRT Selection for AKI Patients With Critical Illness.

机构信息

Department of Nephrology and Endocrinology, The University of Tokyo Hospital, Tokyo, Japan.

Department of Emergency and Critical Care and Medicine, The University of Tokyo Hospital, Tokyo, Japan.

出版信息

Semin Nephrol. 2020 Sep;40(5):498-505. doi: 10.1016/j.semnephrol.2020.08.006.

Abstract

Acute kidney injury (AKI) is a critical burden on intensive care units in Asia. Renal replacement therapy (RRT) acts as strong supportive care for severe AKI. However, various RRT modalities are used in Asia because of the diversity in ethics, climate, geographic features, and socioeconomic status. Extracorporeal blood purification is used commonly in Asian intensive care units; however, intermittent RRT is preferred in developing countries because of cost and infrastructure issues. Conversely, continuous RRT is preferred in developed countries, indicating the predominance of hospital-acquired AKI patients with complications of hemodynamic instability. Peritoneal dialysis is delivered less frequently, although several studies have suggested promising results for peritoneal dialysis in AKI treatment. Of note, not all RRT modalities are available as a standard procedure in some Asian regions, and it is absolutely necessary to develop a sustainable infrastructure that can deliver optimal care for all AKI patients.

摘要

急性肾损伤(AKI)是亚洲重症监护病房的一个重大负担。肾脏替代疗法(RRT)是严重 AKI 的强有力支持性治疗。然而,由于伦理学、气候、地理特征和社会经济地位的多样性,亚洲各地使用了各种 RRT 模式。体外血液净化在亚洲重症监护病房中常用;然而,由于成本和基础设施问题,在发展中国家更倾向于间歇性 RRT。相反,连续性 RRT 在发达国家更受欢迎,这表明医院获得性 AKI 患者伴血流动力学不稳定并发症的比例较高。腹膜透析的应用较少,尽管有几项研究表明腹膜透析在 AKI 治疗中有良好的效果。值得注意的是,并非所有 RRT 模式在亚洲的某些地区都作为标准程序提供,因此,建立一个能够为所有 AKI 患者提供最佳护理的可持续基础设施是绝对必要的。

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