急性肾脏病的概念沿革

The last piece of picture puzzle:conceptual evolution of acute kidney disease

急性肾损伤(AKI)与慢性肾脏病(CKD)的概念,已被临床广泛认可并普遍应用于肾脏病领域的基础研究与临床实践。为定义肾脏病患者由AKI(7 d)过度至CKD(90 d)的阶段,ADQI工作组于2017年提出了急性肾脏病(AKD)的定义和分期。2021年,KDIGO发布专家共识更新了AKD的概念,将肾脏病根据患病持续时间是否超过3个月分为AKD与CKD,并将AKI划分为AKD的一个亚型,提出了AKD依据AKI和CKD的两种分期原则。本文结合AKD的概念革新以及最新研究结果,对AKD的新概念、流行病学、患者管理、临床预后等进行综述,供领域从业人员参考。

A consensus on the concept of acute kidney injury(AKI)and chronic kidney disease(CKD)has been reached and is widely used in basic research and clinical practice.In 2017,to define the stage of progression from AKI(7 d)to CKD(90 d)in patients with kidney diseases(KDs),the Acute Dialysis Quality Initiative(ADQI)working group proposed a consensus on the definition and staging of acute kidney disease(AKD).In 2021,Kidney Disease:Improving Global Outcomes(KDIGO)released an expert consensus to update the concept of AKD,dividing KDs into AKD and CKD based on whether the duration of the disease is more than 3 months,thus considering AKI a subtype of AKD,and proposing two staging principles of for AKD based on AKI or CKD.Referring to the latest elaboration of the concept of AKD by the KDIGO working group in 2021 and the latest studies on AKD,this article reviews the new concept,epidemiology,management strategies,and clinical prognosis of AKD to provide a reference for practitioners.