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老年非心脏手术患者围手术期急性肾损伤的研究进展。

Advances of perioperative acute kidney injury in elderly patients undergoing non-cardiac surgery.

机构信息

Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha 410008.

National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha 410008, China.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2023 May 28;48(5):760-770. doi: 10.11817/j.issn.1672-7347.2023.220629.

Abstract

The risk of developing perioperative acute kidney injury (AKI) in elderly patients increases with age. The combined involvement of aging kidneys, coexisting multiple underlying chronic diseases, and increased exposure to potential renal stressors and nephrotoxic drugs or invasive procedures constitute susceptibility factors for AKI in elderly patients. The perioperative AKI in elderly patients undergoing noncardiac surgery has its own specific population characteristics, so it is necessary to further explore the characteristics of AKI in elderly patients in terms of epidemiology, clinical diagnosis, risk factors, and preventive and curative measures to provide meaningful clinical advice to improve prognosis, accelerate recovery, and reduce medical burden in elderly patients. Since AKI has the fastest-growing incidence in older patients and is associated with a worse prognosis, early detection, early diagnosis, and prevention of AKI are important for elderly patients in the perioperative period. Large, multicenter, randomized controlled clinical studies in elderly non-cardiac surgery patients with AKI can be conducted in the future, with the aim of providing the evidence to reduce of the incidence of AKI and to improve the prognosis of patients.

摘要

老年患者围手术期急性肾损伤(AKI)的风险随着年龄的增长而增加。衰老肾脏的共同受累、并存的多种潜在慢性疾病,以及潜在的肾应激源和肾毒性药物或侵袭性操作暴露的增加,构成了老年患者 AKI 的易感因素。非心脏手术老年患者围手术期 AKI 具有其自身特定的人群特征,因此有必要进一步探讨老年患者 AKI 的流行病学、临床诊断、危险因素和预防及治疗措施的特点,为改善预后、加速康复和减轻老年患者的医疗负担提供有意义的临床建议。由于 AKI 在老年患者中的发病率增长最快,且与预后较差相关,因此围手术期老年患者 AKI 的早期检测、早期诊断和预防非常重要。未来可以针对老年非心脏手术 AKI 患者进行大型、多中心、随机对照的临床研究,旨在提供降低 AKI 发生率和改善患者预后的证据。

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