急性肾损伤的肾脏替代治疗模式选择

Renal replacement therapy modalities for acute kidney injury

严重的急性肾损伤通常需要肾脏替代治疗,间歇性血液透析、腹膜透析、连续性肾脏替代治疗以及延长的间歇性肾脏替代治疗是肾脏替代治疗的4种常见模式。临床实践中某种肾脏替代治疗方式是否优于另一种仍存在争议。肾脏替代治疗模式的选择对患者肾脏短期和长期预后的影响还需要大规模的随机对照研究和更长的随访时间来深入探讨。该文将探讨急性肾损伤相关肾脏替代治疗技术的发展史、目前应用的现状,并对4种治疗模式进行比较,以期帮助临床工作者更深入理解如何对急性肾损伤患者进行精准医疗理念指导下的个性化肾脏替代治疗方案设计。

Severe acute kidney injury usually requires renal replacement therapy.Intermittent hemodialysis,peritoneal dialysis,continuous renal replacement therapy,and prolonged intermittent renal replacement therapy are the four common modalities of renal replacement therapy.Whether one modality of renal replacement therapy is superior to another in clinical practice remains controversial.The impact of the choice of renal replacement therapy modality on the short-term and long-term prognosis of patients needs to be further explored in large-scale randomized controlled studies and a longer follow-up time.This article will discuss the development history of renal replacement therapy for acute kidney injury,the current status of its application,and the comparison of the four treatment modalities,in order to help clinicians have a deeper understanding of how to design individualized renal replacement therapy programs for patients with acute kidney injury under the guidance of the concept of precision medicine.