Renal dysfunction in surgical patients.

IF 3.5 3区医学 Q1 CRITICAL CARE MEDICINE Current Opinion in Critical Care Pub Date : 2024-12-01 Epub Date: 2024-09-02 DOI:10.1097/MCC.0000000000001203

Hendrik Booke, Alexander Zarbock, Melanie Meersch

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Abstract

Purpose of review: To provide an overview of the current diagnostic criteria for acute kidney injury (AKI) including their limitations and to discuss prevention and treatment approaches in the perioperative setting.

Recent findings: AKI is common in the perioperative period and is associated with worse short- and long-term outcomes. Current definitions of AKI have several limitations and lead to delayed recognition of kidney dysfunction which is why novel diagnostic approaches by using renal biomarkers may be helpful. In general, prevention of the development and progression of AKI is vital as a causal treatment for AKI is currently not available. Optimization of kidney perfusion and avoidance of nephrotoxic drugs reduce the occurrence of AKI in surgical patients. Angiotensin II as a new vasopressor, the use of remote ischemic preconditioning, and amino acids may be approaches with a positive effect on the kidneys.

Summary: Evidence suggests that the implementation of supportive measures in patients at high risk for AKI might reduce the occurrence of AKI. Novel biomarkers can help allocating resources by detecting patients at high risk for AKI.

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手术病人的肾功能障碍。

综述的目的：概述急性肾损伤（AKI）的现行诊断标准，包括其局限性，并讨论围手术期的预防和治疗方法：最近的研究结果：AKI 在围手术期很常见，并与短期和长期预后恶化有关。目前对 AKI 的定义存在一些局限性，导致对肾功能障碍的认识延迟，这就是为什么使用肾脏生物标志物的新型诊断方法可能会有所帮助。一般来说，预防 AKI 的发生和发展至关重要，因为目前还没有治疗 AKI 的因果疗法。优化肾脏灌注和避免使用肾毒性药物可减少手术患者 AKI 的发生。血管紧张素 II 作为一种新的血管抑制剂，使用远程缺血预处理和氨基酸可能是对肾脏有积极影响的方法。摘要：有证据表明，对 AKI 高危患者采取支持性措施可能会减少 AKI 的发生。新型生物标志物可通过检测 AKI 高危患者帮助分配资源。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Critical Care 医学-危重病医学

CiteScore

5.90

自引率

3.00%

发文量

172

审稿时长

6-12 weeks

期刊介绍： Current Opinion in Critical Care delivers a broad-based perspective on the most recent and most exciting developments in critical care from across the world. Published bimonthly and featuring thirteen key topics – including the respiratory system, neuroscience, trauma and infectious diseases – the journal’s renowned team of guest editors ensure a balanced, expert assessment of the recently published literature in each respective field with insightful editorials and on-the-mark invited reviews.

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