急性腎損傷之腎臟替代療法

Renal Replacement Therapy in Acute Kidney Injury

陳俊宇(Chun-Yu Chen) ； 吳逸文(I-Wen Wu) ； 許恒榮(Heng-Jung Hsu) ； 李進昌(Chin-Chan Lee)

《腎臟與透析》 27卷4期 (2015/12) Pp. 173-177

https://doi.org/10.6340/KD.2015.27(4).03

摘要

腎臟替代療法(renal replacement therapy, RRT)是當患者發生嚴重急性腎損傷(acute kidney injury, AKI)，且保守治療無法控制病情時，必需採取的關鍵治療。將RRT視為腎臟支持療法，爭取時間來讓衰竭的器官有恢復的機會，施行的時機不應完全參照傳統的腎衰竭的適應症，當預期患者的狀況會持續惡化，應在明顯症狀發生前施行RRT。間歇性血流透析(intermittent hemodislysis, IHD)和連續性腎臟替代療法(continuous renalreplacement therapy, CRRT)在AKI患者似乎在存活率上沒有差別，但對於血流動力學不穩，急性腦傷及肝衰竭患者，應以CRRT優先。

關鍵字

急性腎損傷 ； 腎臟替代療法 ； 血液透析 ； 連續性腎臟替代療法

並列摘要

Renal replacement therapy (RRT) is crucial in severe acute kidney injury (AKI) when conservative treatment cannot control the disease. RRT is viewed as a renal support that may let other failed organs have time to restore function. RRT should be initiated prior to obvious uremic symptoms and when patient is expected to deteriorate, not strictly in accordance with traditional indications of dialysis of renal failure. Intermittent hemodialysis (IHD) and continuous renal replacement therapy (CRRT) seems to have similar survival rate in patients with AKI, but CRRT should be considered as priority when patients having hemodynamic instability, acute liver failure or acute brain injury.

並列關鍵字

acute kidney injury ； renal replacement therapy ； hemodialysis ； continuous renal replacement therapy