Departments of Neurology and Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
Department of Nephrology, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
Crit Care. 2022 Aug 27;26(1):258. doi: 10.1186/s13054-022-04131-9.
Acute kidney injury is a known clinical risk factor for delirium, an acute cognitive dysfunction that is commonly encountered in the critically ill population. In this comprehensive review of clinical and basic research studies, we detail the epidemiology, clinical implications, pathogenesis, and management strategies of patients with acute kidney injury-associated delirium. Specifically addressed are the pathological roles of endogenous toxin or drug accumulation, acute kidney injury-mediated neuroinflammation, and acute kidney injury-associated volume overload as discrete potential biological mechanisms of the condition. The optimization of clinical contributors and normalization of renal function are reviewed as pragmatic management strategies in addition to potential and emerging therapeutic approaches.
急性肾损伤是谵妄的已知临床危险因素，谵妄是危重病患者中常见的急性认知功能障碍。在对临床和基础研究的全面综述中，我们详细描述了与急性肾损伤相关的谵妄患者的流行病学、临床意义、发病机制和管理策略。具体讨论了内源性毒素或药物积累、急性肾损伤介导的神经炎症以及急性肾损伤相关的容量过负荷作为该疾病的离散潜在生物学机制的病理作用。除了潜在和新兴的治疗方法外，我们还回顾了优化临床指标和肾功能正常化作为实用的管理策略。
