Yamamoto T, Hishida A
First Department of Medicine, Hamamatsu University School of Medicine.
Nihon Rinsho. 1995 Aug;53(8):2027-33.
Renal damage attributable to acute circulatory failure includes prerenal azotemia, postischemic acute renal failure and bilateral renal cortical necrosis. In this review, recent findings of the pathophysiology, diagnosis, and treatment of postischemic acute renal failure are reviewed. The medullary thick ascending limb of Henle and the proximal straight tubule are extremely susceptible to ischemic damage because of the characteristic anatomical feature of the vasa recta in the medulla. Appropriate supportive treatment and initiation of dialysis early in the course of acute renal failure improve survival. However, the prognosis of acute renal failure with multiple organ failure is poor. Further studies on the precise cellular mechanism of acute renal failure may provide us with some future modes of treatment.
急性循环衰竭所致的肾损害包括肾前性氮质血症、缺血后急性肾衰竭和双侧肾皮质坏死。在本综述中，对缺血后急性肾衰竭的病理生理学、诊断和治疗的最新研究结果进行了综述。由于髓质直小血管的特征性解剖结构，亨利袢髓质粗升支和近端直小管极易受到缺血损伤。在急性肾衰竭病程早期进行适当的支持治疗并开始透析可提高生存率。然而，伴有多器官功能衰竭的急性肾衰竭预后较差。对急性肾衰竭精确细胞机制的进一步研究可能会为我们提供一些未来的治疗模式。
