Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, 2-124E, Clinical Sciences Building, 8440-112 ST Northwest, Edmonton, Alberta T6G 2B7, Canada.
Division of Nephrology, St. Michael's Hospital and University of Toronto, and Li Ka Shing Knowledge Institute of St. Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada.
Crit Care Clin. 2021 Apr;37(2):409-432. doi: 10.1016/j.ccc.2020.11.005. Epub 2021 Feb 13.
Kidney replacement therapy (KRT) is a core organ support in critical care settings. In patients suitable for escalation in support, who develop acute kidney injury (AKI) complications and urgent indications, there is consensus that KRT should be promptly initiated. In the absence of such urgent indications, the optimal timing has been less certain. Current clinical practice guidelines do not present strong recommendations for when to start KRT for patients with AKI in the absence of life-threatening and urgent indications. This article discusses how best to provide KRT to critically ill patients with severe AKI.
肾脏替代治疗（KRT）是重症监护环境中核心的器官支持手段。对于适合支持治疗升级且出现急性肾损伤（AKI）并发症和紧急指征的患者，共识认为应立即启动 KRT。在没有这些紧急指征的情况下，最佳时机则不太确定。目前的临床实践指南对于无生命威胁和紧急指征的 AKI 患者何时开始 KRT 没有提出强烈的推荐意见。本文讨论了如何为严重 AKI 的重症患者提供最佳的 KRT。
