中国血液净化

中国血液净化 ›› 2017, Vol. 16 ›› Issue (02): 83-85.doi: 10.3969/j.issn.1671-4091.2017.02.004

• 专题 • 上一篇    下一篇

急性肾损伤的的肾脏替代治疗时机

郁胜强1,高翔1   

  1. 第二军医大学附属长征医院肾内科 解放军肾脏病研究所
  • 收稿日期:2016-10-14 修回日期:2016-12-20 出版日期:2017-02-12 发布日期:2017-02-12

The timing of renal replacement therapy in acute kidney injury

  • Received:2016-10-14 Revised:2016-12-20 Online:2017-02-12 Published:2017-02-12

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摘要： 急性肾损伤(acute kidney injury，AKI)是临床常见的危重症，肾脏替代治疗(renal replacement therapy，RRT)已成为AKI 患者的重要治疗手段，但开始RRT 的最佳时机尚无明确结论。目前RRT 治疗时机的界定往往根据血清肌酐(Serum creatinine，SCr)和尿素氮水平(urea nitrogen，BUN)、尿量、重症监护室住院时间以及AKI 分期等。多数临床研究认为早期RRT 能更好地使AKI 患者获益，但也有研究得到相反的结论。要明确找到“早”和“晚”的最佳时间截点，仍需要大规模多中心前瞻性随机对照研究进一步探讨。

关键词: 急性肾损伤, 肾脏替代治疗, 治疗时机

Abstract: Acute kidney injury (AKI) is a common critical disease, and renal replacement therapy (RRT) has become an important treatment for AKI patients. However, there is no consensus about the optimal timing for RRT. At present, several clinical features including serum creatinine, blood urea nitrogen, urine volume, the time admitted to intensive care unit (ICU) and AKI stage are the factors to determine when RRT should be used. Most clinical studies considered that AKI patients may benefit from early RRT, but others had the opposite conclusion. Large scale, multicenter, prospective, and randomized control trials are needed to find out the optimal time point between early and late RRT for AKI patients.

Key words: Acute kidney injury, Renal replacement therapy, Timing of treatment