急性腎臓損傷のリスクのある患者の管理
Jill Vanmassenhove1, Jan Kielstein2, Achim Jörres3
1Renal Division, Ghent University Hospital, Ghent, Belgium.
Lancet (London, England)
|June 1, 2017
まとめ
急性腎臓損傷 (AKI) の予防は早期診断と専門的な教育が不可欠であり,確立されたAKIの治療法はありません. 患者の治療結果を改善するために,体積減少,低血圧,腎毒素を避けることに焦点を当ててください.
科学分野:
- 腎臓科
- クリティカル ケア 医療
- 内科 医学
背景:
- 急性腎損傷 (AKI) は,完全な回復から末期腎疾患まで,患者のアウトカムが変動する複雑な症候群です.
- 現在,AKIが発症したら改善する効果的な介入はなく,予防と早期発見の重要性を強調しています.
研究 の 目的:
- 急性腎臓損傷 (AKI) の管理における予防と早期診断の重要な役割を強調する.
- AKIを診断し管理する医療従事者のための主要な戦略を概説し,有害な結果を回避することに焦点を当てます.
主な方法:
- AKI管理に関する現在の臨床実践と証拠のレビュー.
- 医療従事者のための教育イニシアチブに重点を置く AKIの診断と腎臓毒性攻撃の回避
- 液体管理戦略の議論,液体の回復と過負荷の回避
- 腎置換療法の開始基準の検討
主要な成果:
- AKIの治療法が確立されていないため,予防と早期診断が最重要です.
- 容量減少,低血圧,腎臓毒性物質を避けるための医療専門家の教育は,AKIの結果を改善することができます.
- 電子的早期警告システムは,早期の AKI 検出と管理に役立ちます.
- 過剰な負荷を伴わずに循環を回復するために 液体の管理には注意深いバランスが必要です
- 多くの臨床シナリオでは,コントラスト誘発のAKIのリスクが過大評価されている可能性があります.
結論:
- 急性腎損傷 (AKI) の効果的な治療には 予防戦略と迅速な診断が必要です
- 医療従事者の教育と流体管理の最適化が AKIにおける患者の成果の改善の鍵です
- 流体管理と腎臓置換療法のタイミングは AKIの重要な要素です.
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