认识儿童急性肾损伤

Recognizing pediatric acute kidney injury

摘要:

急性肾损伤（acute kidney injury，AKI）以可逆性的血肌酐和尿素氮升高以及肾脏对水、电解质调节失衡为临床特征。AKI在儿童的发病率逐年升高，住院儿童及成人AKI发病率的增加与其病死率密切相关。继续依赖血肌酐和尿量去诊断AKI导致不能早期提供有效的治疗和支持性的干预措施去阻止和缓解AKI的发生。最近10年实验研究重点在发现和验证在肾功能改变之前识别AKI及有助于鉴别诊断的新的生物标志物。

Abstract:

Acute kidney injury (AKI) is characterized by a reversible increase in blood concentration of creatinine and nitrogenous waste products and by the inability of the kidney to regulate fluid and electrolyte homeostasis appropriately. AKI in hospitalized patients is independently associated with increased morbidity and mortality in pediatric and adult populations. Continued reliance on serum creatinine and urine output for the diagnosis of AKI has resulted in an inability to provide successful therapeutic and supportive interventions to prevent and mitigate AKI. Research efforts over the last decade have foused on the discovery and validation of novel biomarkers to detect AKI prior to a change in kidney function and to make a differential diagnosis of AKI.