【摘要】 急性肾损伤(acute renal injury,AKI)是目前全球关注的热点,死亡率高,是肾内科的急危重症。临床上肾前性AKI最常见,容量负平衡可引起肾小管坏死进而加快进入终末期肾病,因此尽早恢复肾灌注尤为重要。但是导致AKI患者死亡的众多因素中,容量超负荷是引起患者死亡率增加的独立危险因素。因此AKI患者必须早期进行容量评估和管理。初始液体复苏和保守后续液体管理相联合是一种非常有效的容量评估和管理策略。治疗上可选择肾脏替代治疗(renal replacement therapy,RRT)或保守控制液体,但应进行个体化治疗,可使肾功能恢复至基线值,从而明显降低患者的死亡率。更多还原

【Abstract】 Acute kidney injury(AKI) is a critical disease in the nephrology department, and has achieved worldwide attention due to its high mortality rate. Pre-renal injuries are the most common factors causing AKI. Negative volume balance in this situation easily results in renal tubular necrosis and accelerates the progress to end-stage renal disease. Maintenance of normal renal perfusion as soon as possible is extremely urgent. On the other hand, volume overload is an independent risk factor for mortality. Therefore, assessment and management of volume capacity in AKI patients must be carried out as early as possible. An effective volume capacity assessment and management strategy is the combination of the initial fluid for resuscitation and the follow-up conservative liquid management. To make renal function back to the baseline values and to reduce patients’ mortality, renal replacement therapy(RRT) or conservative control of liquid must be individually planned.更多还原