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儿童急性肾损伤(急性肾衰竭)的预防和处理

Author
Prasad Devarajan, MD
Section Editor
Tej K Mattoo, MD, DCH, FRCP
Deputy Editor
Melanie S Kim, MD
Translators
朱光华, 主任医师，教授

引言

急性肾损伤(acute kidney injury, AKI)是指肾功能突然下降，导致肾小球滤过率(glomerular filtration rate, GFR)降低，尿素和其他含氮排泄物潴留，以及细胞外容积和电解质失调。AKI这一术语在很大程度上已取代了术语“急性肾功能衰竭”(acute renal failure, ARF)，因为前者更明确地将肾功能不全定义为肾功能下降的连续性表现，而非肾功能衰竭的不连续表现。

儿科AKI的临床表现范围较广，从血清肌酐轻微增加到无尿性肾功能衰竭不等，其病因多样，可发生在多种不同的临床情境下[1-7]。对于轻度AKI伴脱水，若及时治疗常可完全逆转。然而，病情较为严重的AKI重症患儿的预后仍需谨慎，其死亡率可达50%或更高[8]。

儿童AKI的预防和处理见此专题。儿童AKI的临床表现和诊断，以及新生儿AKI的概述参见其他专题。 (参见“儿童急性肾损伤的临床特征、病因、评估和诊断”和“新生儿急性肾损伤(急性肾衰竭)”)

AKI的预防

已证明有效的措施 — AKI的一般预防措施包括：

●在某些情况下(例如低血容量)应予以补液

                                

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Literature review current through: 2017-06 . | This topic last updated: 2017-01-24.
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