MBBS (Hons), PhD, FRACP, Nephrologist, Northern Health, Vic; Senior Lecturer, Department of Medical Education, University of Melbourne, Vic.
MD, Basic Physician Trainee, Northern Health, Vic; Northern Clinical School, University of Melbourne, Vic.
Aust J Gen Pract. 2021 Jul;50(7):450-456. doi: 10.31128/AJGP-12-20-5774.
The effects of acute kidney injury (AKI) extend beyond the acute illness phase. Patients who survive AKI are at increased risk of hospital readmission, chronic disease including kidney and cardiovascular disease, frailty and death. AKI may be overlooked among more obvious or complex healthcare concerns. While developing a cogent, systemic response to care after AKI is a neglected public health priority, attention to several common challenges may improve patient outcomes.
The aim of this article is to highlight common challenges in managing survivors of AKI and offer suggestions to guide management.
For clinicians managing survivors of AKI, identifying and communicating patient priorities, risk factors and comorbidities including a history of AKI is important. Concurrent management challenges include education regarding lifestyle and pharmacotherapy, managing medication interruptions and dose adjustments, and re-establishing a long-term management plan for chronic diseases.
急性肾损伤 (AKI) 的影响不仅限于急性发病期。存活的 AKI 患者有更高的住院再入院风险、患有慢性疾病（包括肾脏和心血管疾病）、体弱和死亡的风险。在更明显或更复杂的医疗保健问题中，AKI 可能被忽视。虽然制定一个有说服力的、系统性的 AKI 后护理方案是一个被忽视的公共卫生重点，但关注一些常见的挑战可能会改善患者的预后。
本文旨在强调管理 AKI 幸存者时常见的挑战，并提供指导管理的建议。
对于管理 AKI 幸存者的临床医生来说，确定和沟通患者的优先事项、风险因素和合并症（包括 AKI 病史）非常重要。同时存在的管理挑战包括关于生活方式和药物治疗的教育、管理药物中断和剂量调整，以及重新建立慢性疾病的长期管理计划。
