Acute kidney injury in the critically ill: an updated review on pathophysiology and management

被引：0
作者：
Peter Pickkers
Michael Darmon
Eric Hoste
Michael Joannidis
Matthieu Legrand
Marlies Ostermann
John R. Prowle
Antoine Schneider
Miet Schetz
机构：
[1] Radboud University Medical Centre,Department of Intensive Care
[2] Hôpital Saint-Louis,APHP, Service de médecine intensive et de réanimation
[3] Université de Paris,Department of Intensive Care Medicine, Ghent University Hospital
[4] ECSTRA Team,Division of Intensive Care and Emergency Medicine, Department of Internal Medicine
[5] UMR 1153,Department of Anesthesia and Peri
[6] Center of Epidemiology and Biostatistics,Operative Care, Division of Critical Care Medicine
[7] INSERM,Department of Critical Care
[8] Ghent University,Adult Critical Care Unit, Department of Renal Medicine and Transplantation
[9] Research Foundation—Flanders (FWO),William Harvey Research Institute
[10] Medical University of Innsbruck,Clinical Department and Laboratory of Intensive Care Medicine, Division of Cellular and Molecular Medicine
[11] University of California San Francisco,undefined
[12] King’s College London,undefined
[13] Guy’s & St Thomas’ Hospital,undefined
[14] The Royal London Hospital,undefined
[15] Barts Health NHS Trust,undefined
[16] Queen Mary University of London,undefined
[17] Adult Intensive Care Unit,undefined
[18] Centre Hospitalier Universitaire Vaudois (CHUV),undefined
[19] KU Leuven University,undefined
来源：
Intensive Care Medicine | 2021年 / 47卷
关键词：
Acute kidney injury; Diagnosis; Biomarkers; Machine learning; Heterogeneity; Phenotypes; Pathophysiology; Nephrotoxicity; Organ cross-talk; Fluid therapy; Blood pressure management; Vasopressor; Long-term consequences;
D O I：
暂无
中图分类号：
学科分类号：
摘要：
Acute kidney injury (AKI) is now recognized as a heterogeneous syndrome that not only affects acute morbidity and mortality, but also a patient’s long-term prognosis. In this narrative review, an update on various aspects of AKI in critically ill patients will be provided. Focus will be on prediction and early detection of AKI (e.g., the role of biomarkers to identify high-risk patients and the use of machine learning to predict AKI), aspects of pathophysiology and progress in the recognition of different phenotypes of AKI, as well as an update on nephrotoxicity and organ cross-talk. In addition, prevention of AKI (focusing on fluid management, kidney perfusion pressure, and the choice of vasopressor) and supportive treatment of AKI is discussed. Finally, post-AKI risk of long-term sequelae including incident or progression of chronic kidney disease, cardiovascular events and mortality, will be addressed.
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页码：835 / 850
页数：15
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