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急性腎損傷 ( Acute kidney injury ，縮寫為 AKI ，以前稱為「 急性腎衰竭 」 ( acute renal failure、ARF )、 急性腎功能衰竭 )， [1] [2] 通常在7天內腎臟發展為 腎功能 突然損失掉。 [3] 其原因是多方面的。 通常發生原因為腎 組織 損壞造成的結果，其起因為任何病因 (例如 低血壓) 腎血流量 的減少 (腎 缺血 (ischemia))、暴露於 對腎有害的物質 (Nephrotoxicity)、腎 發炎 的過程，或阻塞尿流量的 尿路 阻礙。 AKI診斷是基於特有的實驗室研究結果上、如升高的 尿素氮 及 肌酸酐 ，或 腎臟不能產生足夠量的尿 。
急性腎損傷 ( Acute kidney injury ，缩写为 AKI ，以前稱為「 急性腎衰竭 」 ( acute renal failure、ARF )、 急性腎功能衰竭 )， [1] [2] 通常在7天內腎臟發展為 腎功能 突然損失掉。 [3] 其原因是多方面的。 通常發生原因為腎 組織 損壞造成的結果，其起因為任何病因 (例如 低血壓) 腎血流量 的減少 (腎 缺血 (ischemia))、暴露於 對腎有害的物質 (Nephrotoxicity)、腎 發炎 的過程，或阻塞尿流量的 尿路 阻礙。 AKI診斷是基於特有的實驗室研究結果上、如升高的 尿素氮 及 肌酸酐 ，或 腎臟不能產生足夠量的尿 。
- N17
- 腎臟科
- GB60
2020年1月1日 · 急性腎衰竭 (acute renal failure)，即嚴重的急性腎損傷 (acute kidney injury)，意味著腎臟突然停止正常工作，從而造成代謝廢物、體液和電解質等在體內積聚，引發各種症狀。 如果治療不及時，可能會造成腎臟永久性損傷，甚至導致死亡。 最常見的病因是脫水、大手術或重創造成的失血，或者服用了某些藥物，例如非甾體類抗炎藥 (NSAIDs)、抗生素或用於心臟或血管造影檢查過程中使用的造影劑。 重症監護室患者、高齡老人及長期患有心血管疾病的人群更容易出現急性腎損傷，應多加註意。 如果出現少尿或無尿、腫脹、側腹痛等症狀，應及時就診，以查明是否為腎損傷，並及時治療。 偶然情況下，急性腎功能衰竭會導致腎功能永久喪失或終末期腎病，需要終生透析或腎移植才能存活。
- Signs and Symptoms
- Causes
- Diagnosis
- Treatment
- Prognosis
- Epidemiology
- History
The clinical presentation is often dominated by the underlying cause. The various symptoms of acute kidney injury result from the various disturbances of kidney function that are associated with the disease. Accumulation of urea and other nitrogen-containing substances in the bloodstream lead to a number of symptoms, such as fatigue, loss of appeti...
Prerenal
Prerenal causes of AKI ("pre-renal azotemia") are those that decrease effective blood flow to the kidney and cause a decrease in the glomerular filtration rate (GFR). Both kidneys need to be affected as one kidney is still more than adequate for normal kidney function. Notable causes of prerenal AKI include low blood volume (e.g., dehydration), low blood pressure, heart failure (leading to cardiorenal syndrome), hepatorenal syndrome in the context of liver cirrhosis, and local changes to the...
Intrinsic or renal
Intrinsic AKI refers to disease processes which directly damage the kidney itself. Intrinsic AKI can be due to one or more of the kidney's structures including the glomeruli, kidney tubules, or the interstitium. Common causes of each are glomerulonephritis, acute tubular necrosis (ATN), and acute interstitial nephritis (AIN), respectively. Other causes of intrinsic AKI are rhabdomyolysis and tumor lysis syndrome. Certain medication classes such as calcineurin inhibitors (e.g., tacrolimus) can...
Postrenal
Postrenal AKI refers to acute kidney injury caused by disease states downstream of the kidney and most often occurs as a consequence of urinary tract obstruction. This may be related to benign prostatic hyperplasia, kidney stones, obstructed urinary catheter, bladder stones, or cancer of the bladder, ureters, or prostate.
Definition
Introduced by the KDIGO in 2012,specific criteria exist for the diagnosis of AKI. AKI can be diagnosed if any one of the following is present: 1. Increase in SCr by ≥0.3 mg/dl (≥26.5 μmol/L) within 48 hours; or 2. Increase in SCr to ≥1.5 times baseline, which has occurred within the prior 7 days; or 3. Urine volume < 0.5 mL/kg/h for 6 hours.
Staging
The RIFLE criteria, proposed by the Acute Dialysis Quality Initiative (ADQI) group, aid in assessment of the severity of a person's acute kidney injury. The acronym RIFLE is used to define the spectrum of progressive kidney injury seen in AKI: 1. Risk: 1.5-fold increase in the serum creatinine, or glomerular filtration rate (GFR) decrease by 25 percent, or urine output <0.5 mL/kg per hour for six hours. 2. Injury: Two-fold increase in the serum creatinine, or GFR decrease by 50 percent, or ur...
Evaluation
The deterioration of kidney function may be signaled by a measurable decrease in urine output. Often, it is diagnosed on the basis of blood tests for substances normally eliminated by the kidney: urea and creatinine. Additionally, the ratio of BUN to creatinine is used to evaluate kidney injury. Both tests have their disadvantages. For instance, it takes about 24 hours for the creatinine level to rise, even if both kidneys have ceased to function. A number of alternative markers have been pro...
The management of AKI hinges on identification and treatment of the underlying cause. The main objectives of initial management are to prevent cardiovascular collapse and death and to call for specialist advice from a nephrologist. In addition to treatment of the underlying disorder, management of AKI routinely includes the avoidance of substances ...
Mortality
Mortality after AKI remains high. AKI has a death rate as high as 20%, which may reach up to 50% in the intensive care unit(ICU). Each year, around two million people die of AKI worldwide. AKI develops in 5% to 30% of patients who undergo cardiothoracic surgery, depending on the definition used for AKI.If AKI develops after major abdominal surgery (13.4% of all people who have undergone major abdominal surgery) the risk of death is markedly increased (over 12-fold).
Kidney function
Depending on the cause, a proportion of patients (5–10%) will never regain full kidney function, thus entering end-stage kidney failure and requiring lifelong dialysis or a kidney transplant. Patients with AKI are more likely to die prematurely after being discharged from hospital, even if their kidney function has recovered. The risk of developing chronic kidney diseaseis increased (8.8-fold).
New cases of AKI are unusual but not rare, affecting approximately 0.1% of the UK population per year (2000 ppm/year), 20x incidence of new ESKD (end-stage kidney disease). AKI requiring dialysis (10% of these) is rare (200 ppm/year), 2x incidence of new ESKD. There is an increased incidence of AKI in agricultural workers because of occupational ha...
Before the advancement of modern medicine, acute kidney injury was referred to as uremic poisoning while uremia was contamination of the blood with urine. Starting around 1847, uremia came to be used for reduced urine output, a condition now called oliguria, which was thought to be caused by the urine's mixing with the blood instead of being voided...
- Acute renal failure (ARF), acute kidney failure (AKF)
維基百科，自由的 encyclopedia. 急性腎損傷 ( Acute kidney injury ，縮寫為 AKI ，以前稱為「 急性腎衰竭 」 ( acute renal failure、ARF )、 急性腎功能衰竭 )， [1] [2] 通常在7天內腎臟發展為 腎功能 突然損失掉。 [3] Quick Facts 急性腎損傷 (Acute kidney injury), 類型 ... Close. 其原因是多方面的。 通常發生原因為腎 組織 損壞造成的結果，其起因為任何病因 (例如 低血壓) 腎血流量 的減少 (腎 缺血 (ischemia))、暴露於 對腎有害的物質 (Nephrotoxicity)、腎 發炎 的過程，或阻塞尿流量的 尿路 阻礙。
2024年1月2日 · 急性腎損傷是在短時間內，腎功能急速惡化。 病因. 失血過多：失血、燒傷、手術. 心臟衰竭. 休克. 嚴重的輸血反應、溶血病. 惡性高血壓. 腎感染、敗血症. 腎毒性藥物過量. 急性腎炎. 泌尿道突然阻塞. 臨床分期. 臨床上急性腎損傷的分期以血中肌酸酐 (Cre)濃度的上升或尿量的下降為標準。 第一期急性腎損傷的定義包括：血中肌酸酐濃度上升至基準值的1.5至2倍；血中肌酸酐濃度在48小時內上升超過0.3mg/dl；或尿量小於每小時每公斤0.5ml持續達6小時。 第二期急性腎損傷之定義為：血中肌酸酐濃度上升至基準值的2-3倍； 或尿量小於每小時每公斤0.5ml持續達12小時。
2023年10月11日 · 急性腎損傷是指短時間之內腎功能急遽惡化，根據全球改善腎臟病預後组織（The Kidney Disease: Improving Global Outcomes, KDIGO）的診斷標準及分期如下: 目前也有些新型生物標記如嗜中性白血球明膠酶相關運載蛋白 (neutrophil gelatinase-associated lipocalin,NGAL), 腎損傷分子 (Kidney injury molecule-1, KIM-1)等, 可做為急性腎損傷的診斷，但費用較高。 急性腎損傷的病因與危險因子. 各種原因造成出血、脫水等造成體液容積不足的現象或休克低血壓。 腎毒性藥物及食物、感染併敗血症、腎絲球腎炎、顯影劑注射。 尿路結石、腫瘤、攝護腺肥大等造成尿路阻塞。 心臟衰竭造成之心腎症候群。
