急性肾损伤在临床上如何进行分期 周晓霜 山西省人民医院 скачать в хорошем качестве

急性肾损伤在临床上如何进行分期 周晓霜 山西省人民医院

急性肾损伤在临床上如何进行分期 周晓霜 山西省人民医院 急性肾损伤也叫AcuterenalinjuryAKI既往叫做急性肾衰竭是临床急诊中常见的一种急危重症，指多种病因引起的突发的持续24小时以上的肾功能快速下降临床综合征，临床上主要表现少尿或者无尿，具有发病率高，转为透析的几率比较高死亡风险比较大的临床特征，即可以发生于既往有肾脏病的患者，也可以发生在原有慢性肾脏病的基础上急性加重，治疗强调早诊断早治疗，避免患者进展为尿毒症期至于分期在2012年改善全球肾脏病预后组织KDIGO它发布急性肾损伤的分期标准共分为三期，一期是血清肌酐与基线相比升高大于等于0.3毫克每分，24小时的尿量少于0.5毫升每公斤体重每小时。二期是指血肌酐与基线相比升高2到2.9倍尿量少于0.5毫升每公斤体重每小时。三期是升高大于等于4毫克每分升，也就是大于等于353微摩尔每升需要启动肾脏替代治疗以及尿量少于0.3毫升每公斤体重每小时或者大于等于24小时无尿。 How to stage acute renal injury in clinic Acute renal injury, also known as acutenenalinjury AKI, formerly known as acute renal failure, is a common critical disease in clinical emergency, It refers to the sudden clinical syndrome of rapid decline of renal function lasting more than 24 hours caused by various causes, The main clinical manifestations are oliguria or anuria, It has a high incidence rate. The risk of conversion to dialysis is higher, and the risk of death is higher, It can occur in patients with previous kidney disease, It can also occur on the basis of the original chronic kidney disease, The treatment emphasizes early diagnosis and treatment, KDIGO, a global organization to improve the prognosis of kidney disease in 2012, issued the staging standard of acute renal injury, which is divided into three stages, In the first phase, the serum creatinine level was higher than or equal to 0.3 mg / min compared with the baseline, The 24-hour urine volume is less than 0.5 ml / kg body weight / hour. Phase II is defined as a 2 to 2.9-fold increase in serum creatinine compared to baseline, with urine volume less than 0.5 ml / kg body weight / hour. The third stage is to increase 4 mg / dL or more, That is to say, 353 micromol / L or more needs to start renal replacement therapy and the urine volume is less than 0.3 ml / kg body weight / hour or more than 24 hours without urine.