Acute kidney injury: what's the prognosis?
Acute kidney injury: what's the prognosis?
复制标题
DOI：
10.1038/nrneph.2011.13
复制
发表时间：
2011-04
影响因子：
41.5
通讯作者：
Kellum, John A.
中科院分区：
文献类型：
--
作者：
Murugan, Raghavan;Kellum, John A.
急性肾损伤（阿基）是常见的（特别是在危重病期间），发病率增加，并与相当大的发病率和死亡率相关。风险、损伤、衰竭、损失和终末期肾病（步枪）分类目前提供了阿基发生率和结局的标准化估计。尽管在人类阿基发病机制的理解方面取得了进展，但我们评估肾功能的能力有限，功能损害与肾脏结构损伤的相关性很差。然而，新兴的新型生物标志物可能会进一步加强风险分层，促进早期诊断，使早期登记的治疗试验，并评估预后。脓毒症仍然是重症患者阿基的主要原因，在过去几年中，对脓毒症中阿基发病机制的认识开始将注意力从肾血流转移到炎症介导的器官损伤。新出现的证据表明，与未发生阿基的患者相比，AKI幸存者发生慢性肾脏疾病和终末期肾脏疾病的长期风险。尽管经过数十年的研究，目前除了支持性治疗外，还没有针对阿基的特异性治疗方法，需要进一步的工作来更好地了解危重病期间阿基的发病机制并开发新的治疗方法。
Acute kidney injury (AKI) is common (especially during critical illness), increasing in incidence, and is associated with considerable morbidity and mortality. The Risk, Injury, Failure, Loss, and End-stage renal disease (RIFLE) classification currently provides a standardized estimate of incidence and outcomes from AKI. Despite advances in the understanding of the pathogenesis of human AKI, our ability to assess kidney function is limited and functional impairment poorly correlates with structural injury to the kidneys. Emerging novel biomarkers are, however, likely to further enhance risk stratification, facilitate early diagnosis, enable early enrollment in therapeutic trials, and assess prognosis. Sepsis remains the leading cause of AKI among the critically ill and over the past few years insights into the pathogenesis of AKI in sepsis are beginning to shift attention from renal blood flow to inflammation-mediated organ injury. Emerging evidence suggests that survivors of AKI incur long-term risks for developing chronic kidney disease and end-stage renal disease compared with those without AKI. Despite decades of research, no specific therapy for AKI other than supportive care currently exists and further work is required to better understand the pathogenesis of AKI during critical illness and to develop novel treatments.
登录
查看更多内容
影响因子：
6.1
作者：
Bagshaw, Sean M.;George, Carol;Bellomo, Rinaldo
通讯作者：
Bellomo, Rinaldo
急性肾脏损伤的步枪标准与重症患者的医院死亡率有关：一项队列分析。
影响因子：
15.1
作者：
Hoste, Eric A. J.;Clermont, Gilles;Kersten, Alexander;Venkataraman, Ramesh;Angus, Derek C.;De Bacquer, Dirk;Kellum, John A.
通讯作者：
Kellum, John A.
影响因子：
38.9
作者：
de Mendonça, A;Vincent, JL;Cantraine, F
通讯作者：
Cantraine, F
影响因子：
13.6
作者：
Ishani, Areef;Xue, Jay L.;Collins, Allan J.
通讯作者：
Collins, Allan J.
影响因子：
15.9
作者：
ALEJANDRO, V;SCANDLING, JD;MYERS, BD
通讯作者：
MYERS, BD