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儿科急性肾损伤:重点关注病理生理学的概述。

Acute kidney injury in pediatrics: an overview focusing on pathophysiology.

机构信息

Interdisciplinary Laboratory of Medical Investigation, Department of Pediatrics, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Alfredo Balena Avenue, Number 190, 2nd floor, Room #281, Belo Horizonte, MG, 30130100, Brazil.

出版信息

Pediatr Nephrol. 2022 Sep;37(9):2037-2052. doi: 10.1007/s00467-021-05346-8. Epub 2021 Nov 30.

Abstract

Acute kidney injury (AKI) is defined as an abrupt decline in glomerular filtration rate, with increased serum creatinine and nitrogenous waste products due to several possible etiologies. Incidence in the pediatric population is estimated to be 3.9 per 1,000 hospitalizations, and prevalence among children admitted to intensive care units is 26.9%. Despite being a condition with important incidence and morbimortality, further evidence on pathophysiology and management among the pediatric population is still lacking. This narrative review aimed to summarize and discuss current data on AKI pathophysiology in the pediatric population, considering all the physiological particularities of this age range and common etiologies. Additionally, we reported current diagnostic tools, novel biomarkers, and newly proposed medications that have been studied with the aim of early diagnosis and appropriate treatment of AKI in the future.

摘要

急性肾损伤(AKI)被定义为肾小球滤过率突然下降,由于多种可能的病因,血清肌酐和氮废物产物增加。儿科人群中的发病率估计为每千例住院患者 3.9 例,重症监护病房收治的儿童中发病率为 26.9%。尽管 AKI 是一种发病率和病死率都很高的疾病,但儿科人群的病理生理学和管理方面仍缺乏进一步的证据。本综述旨在总结和讨论儿科人群 AKI 病理生理学的现有数据,同时考虑到该年龄段的所有生理特点和常见病因。此外,我们还报告了目前的诊断工具、新型生物标志物和新提出的药物,这些药物已经被研究用于 AKI 的早期诊断和未来的适当治疗。

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