急性肾损伤诊治进展  

Advances in diagnosis and treatment of acute kidney injury

作　　者：梅长林[1] 刘森炎[1] 

机构地区：[1]上海解放军肾脏病研究所暨第二军医大学附属长征医院肾内科,200003

出　　处：《解放军医学杂志》2013年第5期342-346,共5页Medical Journal of Chinese People's Liberation Army

摘　　要：急性肾损伤是一种常见的临床综合征,主要表现为肾功能急剧下降,其诊断有赖于血肌酐的升高和尿量的减少。急性肾损伤在住院患者尤其是重症患者中十分常见,目前尚无有效的治疗方法,严重时需进行肾脏替代治疗。近年来,急性肾损伤时肾脏替代治疗的方式和剂量一直是研究的热点。重症急性肾损伤患者病死率高,部分存活患者肾功能可完全或部分恢复,脱离透析,但还有部分患者会直接进展到终末期肾病。此外,急性肾损伤患者恢复后发生慢性肾脏病的风险也大大增加。因此,早期诊断、早期干预是改善急性肾损伤预后的关键。用血肌酐水平和尿量对急性肾损伤进行早期诊断不够敏感。目前,许多新的生物学标志物正在研究中,但其有效性还有待验证。Acute kidney injury （AKI） is a clinical syndrome characterized by a rapid loss of kidney function, and its diagnosis depends on an increased serum creatinine and/or decreased urinary output. AKI is common in hospitalized patients and even more common in critically ill patients. At present specific therapies have not been developed in regard to the prevention and treatment of AKI or the strategy to expedite its recovery. Renal replacement therapy is used to support the patients when AKI is serious. In recent years, studies on appropriate treatment modality and drug dosage for renal replacement therapy have become a hot issue for attention. Mortality of serious AKI remains high, particularly in critically ill patients. Some patients who survive may obtain complete or partial recovery from AKI, but in some patients it may directly advanced to end-stage renal disease. In addition, AKI greatly increases the risk of developing chronic kidney disease or-exaggerates pre-existing chronic kidney disease. Early detection and diagnosis of AKI are valuable to improve patients＇ prognosis. New biomarkers that can be more sensitive to detect renal injury are being developed, as kidney damage usually occurs prior to the changes in serum creatinine and urinary output. However, further investigation is mandatory to confirm the effectiveness of these novel biomarkers.

关 键 词：肾损伤 急性 诊断 治疗 

分 类 号：R692.5[医药卫生—泌尿科学]