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Lesiones renales agudas
Marlies Ostermann1, Nuttha Lumlertgul2, Rachel Jeong3
1Department of Critical Care, King's College London, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Lancet (London, England)
|January 18, 2025
Resumen
La lesión renal aguda (IRA) es una afección común con una alta incidencia en los países de bajos ingresos, que conlleva graves consecuencias para la salud a corto y largo plazo. Las estrategias efectivas de atención y los modelos de seguimiento a largo plazo para la IAC requieren más investigación y subfenotipización para intervenciones de precisión.
Área de la Ciencia:
- Nefrología
- Medicina de cuidados intensivos
- Salud pública
Sus antecedentes:
- La lesión renal aguda (IRA) es una condición prevalente y compleja que afecta la función renal.
- La IAC es desproporcionadamente común en los países de ingresos bajos y medios, lo que plantea importantes desafíos para la salud mundial.
- Los impactos a corto plazo incluyen un aumento de la mortalidad, las estadías hospitalarias y los costos de atención médica, mientras que los riesgos a largo plazo implican enfermedad renal crónica y morbilidad cardiovascular.
Objetivo del estudio:
- Revisar la comprensión actual de la lesión renal aguda (IRA).
- Para resaltar la necesidad de subfenotipación para guiar las intervenciones de precisión.
- Discutir las estrategias de atención actuales y futuras para los pacientes con AKI.
Principales métodos:
- Revisión de la literatura de los estudios existentes sobre la incidencia, las complicaciones y el tratamiento de las IAC.
- Análisis de las actuales estrategias de atención de apoyo y modalidades de tratamiento.
- Discusión de la evidencia emergente sobre el subfenotipo de la IAC y el seguimiento a largo plazo.
Principales resultados:
- La IAC es una condición multifactorial con resultados adversos sustanciales a corto y largo plazo.
- La gestión actual de AKI es en gran medida de apoyo, centrándose en las causas y complicaciones subyacentes.
- La creciente evidencia apoya la necesidad de la subfenotipización de AKI para terapias dirigidas.
- Se recomienda un seguimiento a largo plazo, pero aún no se han establecido modelos óptimos de atención.
Conclusiones:
- La lesión renal aguda (IRA) presenta importantes riesgos para la salud a corto y largo plazo, especialmente en entornos con recursos limitados.
- Los enfoques de medicina de precisión, guiados por el subfenotipado de AKI, son cruciales para mejorar los resultados de los pacientes.
- Se necesitan más investigaciones para definir modelos efectivos de atención a largo plazo para los sobrevivientes de IAC.
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