连续性肾脏替代治疗应用于急性肾损伤的时机选择

The timing of continuous renal replacement therapy in acute kidney injury

急性肾损伤(acute kidney injury,AKI)可表现为由多种原因造成的肾功能急剧下降,是影响多器官多系统的临床重症,病死率较高。连续性肾脏替代治疗(continuous renal replacement therapy,CRRT)具有血流动力学稳定、有效清除中大分子、改善炎症状态、精确控制容量负荷等多种优势,在AKI的救治中发挥着重要作用。受循证医学证据所限,CRRT治疗AKI的开始时机和终止时机一直存在不同观点。该文从AKI的定义及分级、CRRT治疗AKI的指征、开始时机及终止时机的选择等方面进行了综述。

Acute kidney injury（AKI） presents as a sharp decline in renal function caused by a variety of reasons.It is a severe clinical challenge affecting multiple organs and multiple systems, with high mortality. Continuous renal replacement therapy（CRRT） plays an important role in the treatment of AKI. Limited by the lack of evidence, the timing of CRRT for AKI remains ambiguous. This article reviews the definition and grading of AKI, the indication and the timing of initiation/termination of CRRT for AKI.