急性肾损伤

A. Ebadat, E. Bui, Carlos V. R. Brown
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引用次数: 0

摘要

在过去的5到10年里,由于以下共识声明/组织建立的标准,急性肾功能衰竭的定义发生了巨大变化:RIFLE(风险、损伤、衰竭、功能丧失、终末期肾病)、AKIN(急性肾损伤网络)和KDIGO(肾脏疾病:改善全球预后)。2002年,急性透析质量倡议的任务是为急性肾损伤(AKI)建立共识声明。首先要做的是提供AKI的标准定义。到目前为止,文献比较具有挑战性,因为研究在肾损伤定义上缺乏一致性。将结果应用于循证临床实践是困难的。该小组创造了“急性肾损伤”这一术语,包括先前的术语,如肾功能衰竭和急性肾小管坏死。这个新术语代表了广泛的肾脏损害,从脱水到需要肾脏替代治疗(RRT)。本文综述了AKI的流行病学、病理生理学、诊断、预防和管理的算法方法。还讨论了特殊情况,包括横纹肌溶解、造影剂肾病和肝肾综合征。表中概述了AKIN的标准、AKI的定义、AKI的鉴别诊断、能够引起AKI的药物、与AKI相关的特定并发症的治疗以及持续RRT的选择。图中显示了RIFLE分类方案和KDIGO分期与预防策略。本综述包含管理算法1个,图2个,表6个,文献85篇。关键词:肾,肾,KDIGO,氮血症,危重症,尿,少尿,肌酐,透析
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
Acute renal failure definitions have changed dramatically over the last 5 to 10 years as a result of criteria established through the following consensus statements/organizations: RIFLE (Risk, Injury, Failure, Loss of function, End stage renal disease), AKIN (Acute Kidney Injury Network), and KDIGO (Kidney Disease: Improving Global Outcomes). In 2002, the Acute Dialysis Quality Initiative was tasked with the goal of establishing a consensus statement for acute kidney injury (AKI). The first order of business was to provide a standard definition of AKI. Up to this point, literature comparison was challenging as studies lacked uniformity in renal injury definitions. Implementing results into evidence-based clinical practice was difficult. The panel coined the term “acute kidney injury,” encompassing previous terms, such as renal failure and acute tubular necrosis. This new terminology represented a broad range of renal insults, from dehydration to those requiring renal replacement therapy (RRT). This review provides an algorithmic approach to the epidemiology, pathophysiology, diagnosis, prevention, and management of AKI. Also discussed are special circumstances, including rhabdomyolysis, contrast-induced nephropathy, and hepatorenal syndrome. Tables outline the AKIN criteria, most current KDIGO consensus guidelines for definition of AKI, differential diagnosis of AKI, agents capable of causing AKI, treatment for specific complications associated with AKI, and options for continuous RRT. Figures show the RIFLE classification scheme and KDIGO staging with prevention strategies. This review contains 1 management algorithm, 2 figures, 6 tables, and 85 references. Keywords: Kidney, renal, KDIGO, azotemia, critical, urine, oliguria, creatinine, dialysis
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