急性腎臓損傷
Claudio Ronco1, Rinaldo Bellomo2, John A Kellum3
1Department of Medicine, University of Padova, Padova, Italy; International Renal Research Institute of Vicenza, Vicenza, Italy; Department of Nephrology, San Bortolo Hospital, Vicenza, Italy.
Lancet (London, England)
|November 29, 2019
まとめ
急性腎臓損傷 (AKI) は,入院患者の10~15%,集中治療室患者の50%以上に影響します. 新しいバイオマーカーと介入は この複雑な状態の管理に 期待を寄せています
科学分野:
- 腎臓科
- クリティカル ケア 医療
背景:
- 急性腎損傷 (Acute Kidney Injury,AKI) は,腎機能の急速な低下によって特徴づけられ,入院患者および重症患者の有意な部分に影響を与えます.
- AKIは慢性腎臓病に発展し 早期発見と治療の必要性を強調しています
- AKIの多様性は,セプシスや心肺神経症候群のような様々な症候群を網羅し,診断と治療を複雑にします.
研究 の 目的:
- 急性腎損傷 (AKI) の定義,発生率,臨床的影響などについて概要を述べる.
- 腎臓損傷の評価と治療戦略の指針における新興バイオマーカーの役割について議論する.
- 臨床的状況とリソースの可用性を考慮して,AKI管理の現在のアプローチをレビューする.
主な方法:
- 急性腎損傷に関する最近の研究と臨床ガイドラインの文献レビュー.
- 異なる患者集団におけるAKIの発生率と流行率の分析
- 新しい腎臓損傷バイオマーカーの診断と予後値の評価
- AKIの様々な介入の有効性に関する証拠のまとめ
主要な成果:
- AKIの発生率は,特に集中治療室 (ICU) で50%を超えています.
- バイオマーカーは,AKIにおけるリスクの階層化とパーソナライズされた治療の改善の可能性を提供します.
- 治療の論争にもかかわらず,ある種の介入の組み合わせを 支持する証拠が増えています.
結論:
- AKIは複雑な症候群で 高い罹患率と死亡率があり 対応策が求められます
- バイオマーカーは早期発見とリスク評価に不可欠であり,治療を誘導する可能性があります.
- 治療の効果は様々ですが,併用された治療は,AKIの管理に有益であるという証拠が増えています.
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