肝硬化與急性腎損傷

Liver Cirrhosis and Acute Kidney Injury

陳鋭溢(Jui-Yi Chen) ； 黃志強(Jyh-Chang Hwang)

《腎臟與透析》 32卷4期 (2020/12) Pp. 176-181

https://doi.org/10.6340/KD.202012_32(4).0003

摘要

大約25～50%急性代償不全肝硬化的病人發生過急性腎損傷（acute kidney injury, AKI）。肝硬化與AKI可分為非肝腎症候群（non-hepatorenal syndrome, non-HRS）和HRS。其中，HRS又分為第一型和第二型。針對non-HRS應針對病因治療、預防感染和出血，而支持療法目標在維持血液動力學的穩定。HRS治療使用血管收縮劑、白蛋白或腎臟替代療法。HRS的死亡率是很高的，因此，瞭解造成肝硬化引起AKI的原因，可以幫助我們選擇適合的治療方式，改善預後。

關鍵字

肝硬化 ； 急性腎損傷 ； 肝腎症候群

並列摘要

Acute kidney injury (AKI) occurs in approximately 25 ~ 50% decompensated liver cirrhosis. Liver cirrhosis with acute kidney injury including non-hepatorenal syndrome (non-HRS) and HRS. The hepatorenal syndrome includes type 1 and type 2. The strategy for managing non-HRS includes treatment of the underlying causes, prevention for infection, and bleeding episodes. The goal of supporting treatment is to maintain hemodynamic stability. Specific therapies for the HRS are vasoconstrictor drugs, albumin, or renal replacement therapy. The mortality of patients with HRS is high. Therefore, understanding the cause of liver cirrhosis with AKI may help us to choose the appropriate therapy for improving prognosis.

並列關鍵字

liver cirrhosis ； acute kidney injury ； hepatorenal syndrome