Acute kidney injury: short-term and long-term effects.
Acute kidney injury: short-term and long-term effects.
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DOI：
10.1186/s13054-016-1353-y
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发表时间：
2016-07-04
期刊：
影响因子：
--
通讯作者：
Forni LG
中科院分区：
文献类型：
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作者：
Doyle JF;Forni LG
急性肾损伤（阿基）是危重成人器官功能障碍的最常见原因，无论分期如何，阿基的单次发作都具有显著的发病率和死亡率风险。由于已就阿基命名达成共识，反映结局的数据变得更加明显，从而可以对短期和长期结局进行研究。通常，阿基的短期效应可以被认为是反映肾功能本身急性恶化的效应。然而，阿基的影响，特别是关于远距离器官功能（“器官串扰”），正在被阐明，因为对其他疾病的易感性增加。关于长期影响，认为结局是透析与否或生存与否的简单二元终点过于简单化，现实要复杂得多。还讨论了目前可用的治疗策略，以减轻这些不良反应，因为它们有可能改善患者的结果，并提供可观的经济健康储蓄。展望未来，如果我们要评估和外推新疗法的疗效，就需要对肾脏恢复的定义达成一致。未来的研究应侧重于通过长期结果评估的靶向治疗。
Acute kidney injury (AKI) is the most common cause of organ dysfunction in critically ill adults, with a single episode of AKI, regardless of stage, carrying a significant morbidity and mortality risk. Since the consensus on AKI nomenclature has been reached, data reflecting outcomes have become more apparent allowing investigation of both short- and long-term outcomes. Classically the short-term effects of AKI can be thought of as those reflecting an acute deterioration in renal function per se. However, the effects of AKI, especially with regard to distant organ function (“organ cross-talk”), are being elucidated as is the increased susceptibility to other conditions. With regards to the long-term effects, the consideration that outcome is a simple binary endpoint of dialysis or not, or survival or not, is overly simplistic, with the reality being much more complex. Also discussed are currently available treatment strategies to mitigate these adverse effects, as they have the potential to improve patient outcome and provide considerable economic health savings. Moving forward, an agreement for defining renal recovery is warranted if we are to assess and extrapolate the efficacy of novel therapies. Future research should focus on targeted therapies assessed by measure of long-term outcomes.