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脓毒症相关性急性肾损伤的治疗标准。

Sepsis-associated acute kidney injury-treatment standard.

机构信息

Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital of Münster, Münster, Germany and Outcomes Research Consortium, Cleveland, OH, USA.

Section of Nephrology, Department of Medicine, University of Chicago, Chicago, IL, USA.

出版信息

Nephrol Dial Transplant. 2023 Dec 20;39(1):26-35. doi: 10.1093/ndt/gfad142.

Abstract

Sepsis is a host's deleterious response to infection, which could lead to life-threatening organ dysfunction. Sepsis-associated acute kidney injury (SA-AKI) is the most frequent organ dysfunction and is associated with increased morbidity and mortality. Sepsis contributes to ≈50% of all AKI in critically ill adult patients. A growing body of evidence has unveiled key aspects of the clinical risk factors, pathobiology, response to treatment and elements of renal recovery that have advanced our ability to detect, prevent and treat SA-AKI. Despite these advancements, SA-AKI remains a critical clinical condition and a major health burden, and further studies are needed to diminish the short and long-term consequences of SA-AKI. We review the current treatment standards and discuss novel developments in the pathophysiology, diagnosis, outcome prediction and management of SA-AKI.

摘要

脓毒症是宿主对感染的有害反应,可导致危及生命的器官功能障碍。与脓毒症相关的急性肾损伤(SA-AKI)是最常见的器官功能障碍,与发病率和死亡率增加相关。脓毒症导致 ≈50%的危重症成年患者的急性肾损伤。越来越多的证据揭示了临床危险因素、病理生物学、对治疗的反应以及肾脏恢复的要素等方面的关键方面,这些方面提高了我们检测、预防和治疗 SA-AKI 的能力。尽管取得了这些进展,但 SA-AKI 仍然是一种严重的临床状况,也是一个主要的健康负担,需要进一步的研究来减轻 SA-AKI 的短期和长期后果。我们回顾了目前的治疗标准,并讨论了 SA-AKI 的病理生理学、诊断、预后预测和管理方面的新进展。

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