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烧伤相关性急性肾损伤的管理和结局:文献综述。

Management and Outcomes of Acute Kidney Injury due to Burns: A Literature Review.

机构信息

Department of Surgery, Division of Burn Surgery/Paul and Carol David Foundation Burn Institute, Akron Children's Hospital, Akron, OH 44308-1062, USA.

Northeast Ohio Medical University, Rootstown, OH 44272, USA.

出版信息

J Burn Care Res. 2024 Mar 4;45(2):323-337. doi: 10.1093/jbcr/irad121.

Abstract

Acute kidney injury (AKI), a common and severe complication following burn injuries, presents a significant challenge due to its broad clinical manifestations and diverse etiologies. AKI, previously known as acute renal failure, can present abruptly following burns or thermal injuries, causing detrimental health outcomes such as progressive kidney dysfunction, increased hospital length of stay, and requirement of renal replacement therapy (RRT). AKI affects the maintenance of homeostasis of fluid and electrolytes, elimination of metabolic wastes and byproducts, and acid-base balance. Aggressive nutritional support is particularly necessitated in burn patients to prevent protein-energy wasting and a negative nitrogen balance. Understanding the pathogenesis of AKI in burns and improving its prevention and early diagnosis are active areas of research in this field. Despite the potential benefits, the optimal timing and threshold for RRT initiation in burn patients with AKI remain unclear, warranting further studies. Ongoing investigations focus on refining RRT techniques, evaluating biomarkers for early detection of AKI, and exploring adjunctive therapies to enhance renal recovery. The aim of this study is to review the etiology, diagnostic tools, and interventions that improve outcomes associated with AKI in burn-related settings.

摘要

急性肾损伤(AKI)是烧伤后常见且严重的并发症,由于其广泛的临床表现和多种病因,给临床诊治带来了极大的挑战。AKI 以前称为急性肾衰竭,可在烧伤或热损伤后突然发生,导致进行性肾功能障碍、住院时间延长和需要肾脏替代治疗(RRT)等不良健康后果。AKI 影响水和电解质的内环境平衡、代谢废物和副产物的清除以及酸碱平衡的维持。烧伤患者特别需要积极的营养支持,以防止蛋白质-能量消耗和负氮平衡。了解烧伤 AKI 的发病机制并改善其预防和早期诊断是该领域的研究热点。尽管有潜在的益处,但烧伤 AKI 患者开始 RRT 的最佳时机和阈值仍不清楚,需要进一步研究。目前的研究重点是改进 RRT 技术、评估早期 AKI 的生物标志物以及探索辅助治疗以增强肾脏恢复。本研究旨在综述烧伤相关 AKI 的病因、诊断工具和干预措施,以改善 AKI 相关结局。

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