中国血液净化 ›› 2015, Vol. 14 ›› Issue (12): 742-745.doi: 10.3969/j.issn.1671-4091.2015.12.012

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急性肾损伤-监护病房多器官功能障碍综合征衰竭之代名词

林展宇,陈永昌,方基存   

  1. 林口长庚纪念医院肾脏科
  • 收稿日期:2015-09-15 修回日期:2015-09-24 出版日期:2015-12-12 发布日期:2015-12-12
  • 通讯作者: 林展宇r5234@adm.cgmh.org.tw E-mail:r5234@adm.cgmh.org.tw

Acute kidney injury: a delegate of multiple organ failure in intensive care units

  • Received:2015-09-15 Revised:2015-09-24 Online:2015-12-12 Published:2015-12-12

摘要: 监护病房的患者,出现急性肾损伤是一个常见的严重并发症。尽管肾脏替代疗法在近年来已经有极大的进步,急性肾损伤的重症患者死亡率仍然高居不下。高死亡率的原因可能是住进监护病房的患者年龄比以往更大而且并发症更多。目前的研究已经知道与急性肾损伤相关的病理生理因子也经常与其他器官衰竭有关联,这也使得急性肾损伤往往是多器官功能障碍综合征的代名词。之前,医务人员对于急性肾损伤的定义仍缺乏共识。直到最近,新的急性肾损伤定义RIFLE criteria 和修订版本AKINcriteria已经被广为接受,而且被成功的应用于临床研究。

关键词: 急性肾损伤, 叶克膜, 肝硬化, 败血症, 急性呼吸窘迫综合征, 监护病房

Abstract: Acute kidney injury (AKI) is a common and serious complication in critically ill patients. The mortality rate remains high despite improved renal replacement techniques. A possible cause of the high mortality rate is that intensive care unit patients tend to be older and more debilitated than before. Pathophysiological
factors associated with AKI are also incriminated in the failure of other organs, indicating that AKI is often part of a multiple organ failure syndrome. Until recently, practitioners lacked consensus as to the best definition of AKI. The introduction of the RIFLE (Risk, Injury, Failure, Loss, and End-stage kidney disease) criteria and the modified version proposed by the Acute Kidney Injury Network (AKIN) have increased the conceptual understanding of AKI, and these criteria have been successfully tested in clinical studies.

Key words: Acute kidney injury, Extracorporeal membrane oxygenation, Cirrhosis, Sepsis, Acute respiratory, distress syndrome, Intensive care unit