[急性肾损伤防治]。

Lakartidningen Pub Date : 2025-05-27
Max Bell, Carl M Öberg, Marcus Ewert Broman
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引用次数: 0

摘要

急性肾损伤是一种异质性多因素综合征。尽管存在新的生物标志物,肌酐水平或利尿的变化——这两种肾功能指标——仍然被用于评估肾损伤。肾脏还有其他一些功能,如调节体液平衡、电解质平衡和血流动力学。此外,肾脏具有内分泌活性,并分泌肾素和促红细胞生成素等物质。肾脏的所有功能都会受损。急性肾损伤与发病率和死亡率的增加显著相关。急性肾损伤常继发于其他疾病或器官衰竭。在门诊遇到急性肾损伤患者时,必须首先评估是否存在危及生命的情况,如高钾血症、严重代谢性酸中毒和体液积聚,如果存在,应立即将患者转至急诊科。如果没有立即危及生命的情况,应该确定可以逆转肾衰竭的因素。如果这是不成功的,病人应该转介到肾病专家。危重患者的急性肾损伤通常与其他严重的多器官衰竭有关。应仔细监测AKI,并尽可能保护肾脏,如果肾功能恶化,应开始肾脏替代治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Acute kidney injury - prevention and treatment].

Acute kidney injury is a heterogeneous multifactorial syndrome. Despite the existence of new biomarkers, changes in creatinine level or diuresis - both measures of kidney function - are still used to rate kidney injury. The kidney has several other functions, such as regulation of fluid balance, electrolyte balance, and hemodynamics. In addition, the kidney is endocrinologically active and secretes, among other things, renin and erythropoietin. All functions of the kidney can be impaired. Acute kidney injury is significantly associated with increased morbidity and mortality. Acute kidney injury often occurs secondarily to other diseases or organ failures. When encountering a patient with acute kidney injury in outpatient care, one must first assess whether life-threatening conditions such as hyperkalemia, severe metabolic acidosis, and fluid accumulation exist and, if so, promptly refer the patient to the emergency department. If there are no immediately life-threatening conditions, factors that can reverse kidney failure should be identified. If this is not successful, the patient should be referred to a nephrologist. Acute kidney injury in critically ill patients is often linked to other severe multi-organ failures. AKI should be carefully monitored and the kidneys should be protected as much as possible, and if kidney function deteriorates, renal replacement therapy should be initiated.

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来源期刊
Lakartidningen
Lakartidningen Medicine-Medicine (all)
CiteScore
0.30
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发文量
134
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