急性肾脏病的概念与分期及流行病学

Definition,stage,and epidemiology of acute kidney disease

急性肾损伤(AKI)和慢性肾脏病(CKD)是相互关联的临床综合征,均表现为肾脏受损和肾小球滤过率(GFR)下降。研究表明AKI后肾功能完全恢复的患者仍有可能存在肾脏结构的异常,从而增加CKD和终末期肾脏病(ESRD)的风险。然而,部分患者肾脏功能损伤和结构异常可能达不到目前AKI或CKD的诊断标准。因此,2012年KDIGO关于AKI临床实践指南提出了一个新的概念-急性肾脏病和功能障碍,包括了AKI和其他最新研究认识的不符合AKI或CKD诊断标准的肾脏疾病。这一概念的提出有助于增加对各种急慢性肾脏疾病的识别和交流,并提高肾脏病领域相关的医疗、科研和公共卫生水平。本文阐述了急性肾脏病(AKD)的概念和分期,同时介绍了AKD相关的流行病学现状以及未来研究方向,旨在帮助临床医师正确识别和评估各种急慢性肾脏疾病。

Acute kidney injury （AKI） and chronic kidney disease （CKD） are interconnected clinical syndromes, and both manifest kidney injury and a decrease in glomerular filtration rate （GFR）. Studies have shown that patients with AKI may still have abnormalities in the renal structure after complete recovery of renal function, thereby inereasing the risk of CKD and end- stage renal disease （ ESRD ）. However, some patients with renal dysfunction and struetural abnormalities may not reach the current diagnostic eriteria of AKI or CKD. Therefore, in 2012, the Kidney Disease： Improving Global Outcomes （KDIGO） clinical practice guidelines for AKI put forward a new concept, acute kidney diseases and disorders, which includes AKI and other newly-identified kidney diseases that do not meet AKI or CKD diagnostic criteria. This new eoneept was proposed to help inerease the identifieation and exchange of various aeute and ehronie kidney diseases, and to increase the medical, seientifie, and publie health levels of the kidney disease field. This article described the concept and staging of acute kidney disease （ AKD）, as well as the current epidemiologieal status of AKD and future research directions, aiming to help clinicians correctly identify and assess various acute and chronic kidney diseases.