老年急性肾损伤的特点与诊治进展

Acute kidney injury in the elderly:characteristic and progress on diagnosis and treatment

急性肾损伤在老年人群中高发,特别是重症监护病房的老年患者。急性肾损伤的特点是肾功能的快速减退,出现明显氮质血症、水电解质紊乱和酸碱失衡。在过去几十年间,尽管在早期诊断和治疗方面进行了很多研究,急性肾损伤的死亡率并没有明显降低。老年人有许多容易发生急性肾损伤的易感因素,包括肾脏衰老、合并许多共患疾病(如高血压、糖尿病、心脏病、慢性肾脏病、肿瘤)以及由此进行的医疗处理,包括手术、应用造影剂和多种治疗药物。本文总结了老年人急性肾损伤的危险因素、发病率和死亡率特点。由于有关老年人急性肾损伤的研究较少,今后需进一步开展此方面的研究。

The incidence of acute kidney injury(AKI)is high among elderly populations,especially in intensive care units(ICUs),which is characterized by a sudden declined renal function with consequent increase of nitrogenous products,hydroelectrolytic and acid-base disorders.During the last few decades,the overall mortality of AKI patients remains high despite many technical and therapeutic advances have developed.Several conditions predispose the elderly to progress with AKI,either due to kidney senescence,or because of the high prevalence of comorbidities,such as hypertension,diabetes mellitus,heart diseases,chronic renal disease,neoplasia and medical interventions including surgeries,the use of contrasts and medications.This review is elaborate to assess the incidence,risk factors,and mortality of AKI in elderly patients.Considering the scarcity of studies on AKI in the elderly,further studies are needed.