臨床指引回顧－急性腎臟損傷的評估與治療

Review of Clinical Guidelines - Evaluation and Treatment of Acute Kidney Injury

廖峻緯(Chun-Wei Liao) ； 張弘育(Hung-Yu Chang) ； 林俊良(Chun-Liang Lin) ； 董淳武(Chun-Wu Tung)

《腎臟與透析》 29卷3期 (2017/09) Pp. 101-106

https://doi.org/10.6340/KD.2017.29(3).01

摘要

急性腎臟損傷有極高的發病和死亡率，同時也是醫療系統的一大負擔。早期的評估、診斷及儘速地給予治療是影響病人預後的重要關鍵。找出高風險族群、避免暴露因子、補充足夠體液以及密切地監控血清肌酐酸和尿量的變化是目前預防及早期診斷的要素。本文將回顧近年來的臨床治療指引和重要文獻，內容包含定義、風險評估、早期診斷生物標記的發展，以及目前最新治療的觀念。而對於急性腎臟損傷的透析治療，我們應有腎臟支持而非替代的概念以減少其他器官的負擔。

關鍵字

急性腎臟損傷 ； 評估 ； 治療 ； 臨床指引

並列摘要

Acute kidney injury (AKI) is associated with high incidence and mortality rates, and leads to great economic and health-care burdens. Early assessment, diagnosis and interventions as soon as possible are important factors affecting the prognosis of patients with AKI. Identifying high-risk groups, avoiding exposure factors, supplementing adequate body fluids, and closely monitoring changes in serum creatinine and urine output are key elements of prevention and early identification of AKI. We reviewed recently published clinical guidelines and important literatures, from definition, risk assessment, new biomarkers for early diagnosis, and finally to discuss the current concept of treatment. As for dialysis therapy in patients with AKI, we once again emphasize the concept of ＂renal support＂ rather than ＂renal replacement＂ to reduce the load on other organs.

並列關鍵字

acute kidney injury ； evaluation ； treatment ； clinical guidelines