肾脏替代治疗的启动,何时为宜?  

Timing of initiation of renal replacement therapy for acute kidney injury

作　　者：刘光云[1] 杜斌[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院内科重症医学科,100730

出　　处：《中华重症医学电子杂志》2017年第1期14-17,共4页Chinese Journal Of Critical Care & Intensive Care Medicine(Electronic Edition)

摘　　要：急性肾损伤是重症患者常见的临床表现之一,罹患率及致死率很高,肾脏替代治疗已成为其主要治疗方法。及时恰当使用肾脏替代治疗可缓解病情,已有多项研究探讨肾脏替代治疗的最佳启动时机,但尚无统一定论。对早期定义的不同可能是结果不一的主要原因。临床实践中,需根据不同疾病的不同阶段作出个体化治疗。以急性肾损伤生物标志物为基础确定肾脏替代治疗的适宜时机尚有待进一步研究证实。Acute kidney injury （AKI） is one of the most common organ dysfunction in critically ill patients, with high morbidity and mortality. Renal replacement therapy （RRT） remains the cornerstone in the treatment of severe AKI. Multiple clinical studies with regards to optimal timing of initiation of RRT showed mixed results despite the perception that timely initiation of RRT might improve clinical outcome in patients with AKI, with inconsistent definition of early versus late initiation of RRT in different clinical studies. In clinical practice, the decision to initiate RRT should be individualized with the consideration of clinical context. Biomarker-based strategy of initiation of RRT still merits validation of further clinical studies.

关 键 词：急性肾功能不全 肾替代疗法 启动时机 

分 类 号：R459.5[医药卫生—治疗学]