在肝硬化中急性损伤
Rose Mary Attieh1, Hani M Wadei1
1Department of Transplant, Division of Kidney and Pancreas Transplant, Mayo Clinic, Jacksonville, FL 32224, USA.
Diagnostics (Basel, Switzerland)
|July 29, 2023
概括
急性损伤 (AKI) 影响了近20%的肝硬化患者,而前性亚热血症很常见. 新的诊断工具和治疗方法正在改善这些高风险个体的AKI管理.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 肝病学 肝病学是一种肝病学.
- 内部医学 内部医学
背景情况:
- 急性损伤 (AKI) 是肝硬化的常见并发症,影响近20%的患者.
- 前性亚血症是肝硬化中AKI的最常见原因,导致生存率较差,特别是肝综合征 (HRS) 或急性管状亡 (ATN).
研究的目的:
- 审查AKI定义和分类中针对肝硬化患者的最新进展.
- 讨论关于白素和特里普林素在治疗肝硬化中的AKI疗效和风险的新兴知识.
- 突出新的诊断工具,包括尿路生物标志物和护理点超声波 (POCUS),用于AKI的差异化和管理.
主要方法:
- 对肝硬化中AKI的当前文献的综述.
- 分析新的诊断标准和治疗指南.
- 评估新兴的诊断技术,如尿路生物标志物和POCUS.
主要成果:
- 肝硬化中的AKI与患者存活率明显降低有关.
- 新的分类和诊断工具正在变得可用,以改进AKI评估.
- 在AKI中使用白蛋白和特里普林素的理解正在演变.
结论:
- AKI仍然是肝硬化的关键并发症,对生存有重大影响.
- 最近的分类,治疗和诊断方面的更新为肝硬化患者的AKI管理提供了改进的策略.
- 未来的管理可能将集成先进的诊断,如POCUS和生物标志物,用于精确的AKI差异化和向治疗.
关键词:
肝发性综合征 肝发性综合征
相关概念视频
01:22Acute Kidney Injury I: Introduction
32
Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
32
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
35
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
35
01:29Acute Kidney Injury III: Clinical Manifestations
34
Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
34
01:29Acute Kidney Injury II: Pathophysiology
31
Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
31
01:20Acute Kidney Injury V: Interprofessional Care
25
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
25
01:22Acute Kidney Injury VI: Nursing Management
32
Acute Kidney Injury (AKI) results in an inability to maintain fluid, electrolyte, and acid-base balance. Effective nursing management is critical in improving patient outcomes and includes comprehensive patient assessment and targeted interventions.Comprehensive Patient AssessmentA detailed history collection is essential, focusing on any recent infections, nephrotoxic medication use, or chronic conditions such as hypertension and diabetes that may contribute to AKI. During the physical...
32