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[急性肾衰竭的治疗]

[Treatment of acute kidney failure].

作者信息

Canaud B, Leray-Moragues H

机构信息

Service de néphrologie Hôpital Lapeyronie, Montpellier.

出版信息

Rev Prat. 1995 Sep 1;45(13):1653-61.

PMID:7569694
Abstract

The appropriate treatment of acute renal failure (ARF) is a function of its type and of its underlying causes. Functional ARF requires medical treatment directed towards the correction of kidney hemodynamic disequilibrium and the restoration of adequate glomerular filtration rate (suppression of drugs, correction of hypovolemia, hypotension or shock by vascular refilling and inotropic drug therapy). Obstructive ARF requires restoration of urinary tract patency by urological intervention (internal or external urinary catheter shunt) and treatment of factors underlying the obstruction (lithotomy, steroids, radio and (or) chemotherapy). Organic ARF commonly necessitates referral to a nephrology unit for renal replacement therapy, the choice of treatment modality (hemodialysis, hemofiltration, peritoneal dialysis) depending upon availability and staff expertise as well as patient clinical condition, associated comorbidity and gravity of ARF.

摘要

急性肾衰竭(ARF)的恰当治疗取决于其类型及潜在病因。功能性ARF需要针对纠正肾脏血流动力学失衡及恢复足够肾小球滤过率的内科治疗(停用药物、通过补充血容量及使用正性肌力药物治疗纠正血容量不足、低血压或休克)。梗阻性ARF需要通过泌尿外科干预恢复尿路通畅(内置或外置导尿管分流)并治疗梗阻的潜在因素(取石术、使用类固醇、放疗及(或)化疗)。器质性ARF通常需要转诊至肾病科进行肾脏替代治疗,治疗方式(血液透析、血液滤过、腹膜透析)的选择取决于可利用的资源、工作人员的专业技能以及患者的临床状况、合并症及ARF的严重程度。

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