重症监护病房的严重急性肾损伤：分步管理。

IF 4.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

European Heart Journal: Acute Cardiovascular Care Pub Date : 2025-10-12 DOI:10.1093/ehjacc/zuaf084

Mauro Riccardi, Matteo Pagnesi, Carlo M Lombardi, Marco Metra

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引用次数: 0

摘要

急性肾损伤（AKI）是一种持续7天的突然肾功能丧失，伴有基础血清肌酐水平升高和/或尿量减少。AKI是重症监护病房（ICU）的常见疾病，在急性心力衰竭住院患者中发生率为13%至36%，在心源性休克（CS）患者中高达80%。需要透析的AKI也很常见（5% - 8%），在CS患者中可超过13%。AKI在短期内（特别是需要透析时）和长期内均与死亡率增加相关。本综述的目的是为ICU中液体负荷过重的严重AKI患者提供从药物治疗到肾脏替代治疗的逐步管理的最新进展。

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Severe acute kidney injury in the intensive care unit: step-to-step management.

Acute kidney injury (AKI) is a sudden loss of renal function limited to 7 days with increased basal serum creatinine levels and/or decreased urinary production. AKI is a frequent condition in the intensive care unit (ICU) ranging from 13% to 36% in patients hospitalized with acute heart failure, up to 80% in patients with cardiogenic shock (CS). AKI requiring dialysis is also common (5% to 8%) and can exceed 13% in patients with CS. AKI is consistently associated with increased mortality in both the short-term, especially when dialysis is needed, and the long-term. The aim of this review is to provide an update on step-by-step management, from pharmacological treatment to renal replacement therapy, in patients with severe AKI in ICU patients with fluid overload.

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来源期刊

European Heart Journal: Acute Cardiovascular Care Medicine-General Medicine

CiteScore

8.50

自引率

4.90%

发文量

325

期刊介绍： The European Heart Journal - Acute Cardiovascular Care (EHJ-ACVC) offers a unique integrative approach by combining the expertise of the different sub specialties of cardiology, emergency and intensive care medicine in the management of patients with acute cardiovascular syndromes. Reading through the journal, cardiologists and all other healthcare professionals can access continuous updates that may help them to improve the quality of care and the outcome for patients with acute cardiovascular diseases.