Renal recovery.

Renal recovery.
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DOI:
10.1186/cc13180
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发表时间:
2014-01-06
期刊:
Critical care (London, England)
影响因子:
--
通讯作者:
Kellum JA
Kellum JA
中科院分区:
其他
文献类型:
--
作者:
Goldstein SL;Chawla L;Ronco C;Kellum JA

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在过去的十年中,急性肾损伤(阿基)研究主要集中在标准阿基定义的发展,早期新型生物标志物的验证,以预测血清肌酐升高之前的阿基和预测阿基严重程度,以及肾脏替代疗法及其对生存率的影响的评估。鉴于阿基和急性期死亡率之间的独立关联,这种关注具有紧迫意义。最近,认识到阿基与慢性肾脏疾病和终末期肾脏疾病的后续发展相关,伴随着死亡率的增加,已经引起了对临床流行病学和危重患者阿基事件后肾脏恢复的机制理解的兴趣。我们回顾了目前关于阿基事件后肾脏恢复的知识,包括肾脏替代治疗的开始时间和方式影响,生物标志物评估和机制目标,以指导未来潜在的临床试验。
Acute kidney injury (AKI) research in the past decade has mostly focused upon development of a standard AKI definition, validation of early novel biomarkers to predict AKI prior to serum creatinine rise and predict AKI severity, and assessment of aspects of renal replacement therapies and their impact on survival. Given the independent association between AKI and mortality in the acute phase, such focus makes imminent sense. More recently, the recognition that AKI is associated with subsequent development of chronic kidney disease and end-stage renal disease, with the attendant increase in mortality, has led to interest in the clinical epidemiology and the mechanistic understanding of renal recovery after an AKI episode in critically ill patients. We review the current knowledge surrounding renal recovery after an AKI episode, including renal replacement therapy initiation timing and modality impact, biomarker assessment and mechanistic targets to guide potential future clinical trials.
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