从急性肾功能衰竭到急性肾损伤认识的转变谈麻醉管理对肾脏的保护

Anesthetic management for renal protection on the change of viewpoint from acute renal failure to acute kidney injury

背景对患者肾功能的保护是临床诊疗过程中的重要目标，改善全球肾病预后组织 （kidney disease improvingglobal outcomes, KDIGO）曾先后多次制定了相关肾病的治疗指南。目的概述急性肾损伤（acutekidneyinjury，AKI）的相关研究及其临床意义。内容AKI概念的产生、围术期麻醉管理对肾功能的影响及AKI治疗的争议。趋向AKI体现了疾病动态演变的过程，提高了对肾损伤的认识，有利于围手术期肾功能的保护。

Background Renal protection is an important concerns in the process of clinical diagnosis and treatment, and the guidelines for kidney disease have been revised many times by kidney disease improving global outcomes （KDIGO）. Objective To review the clinical significance and correlation studies of acute kidney injury （AKI）. Content To review the generation of AKI concept, effects of perioperative anesthesia management on renal function, and the controversy regarding AKI treatment. Trend AKI reflects the process of the dynamic evolution of the disease, and improves the recognition of renal injury, which is conducive to the protection of renal function during perioperative period.