认识儿童急性肾损伤

吴小川

中国当代儿科杂志 ›› 2014, Vol. 16 ›› Issue (4) : 345-348.

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中国当代儿科杂志 ›› 2014, Vol. 16 ›› Issue (4) : 345-348. DOI: 10.7499/j.issn.1008-8830.2014.04.007
环境与肾损伤专题

认识儿童急性肾损伤

  • 吴小川
作者信息 +

Recognizing pediatric acute kidney injury

  • WU Xiao-Chuan
Author information +
文章历史 +

摘要

急性肾损伤(acute kidney injury,AKI)以可逆性的血肌酐和尿素氮升高以及肾脏对水、电解质调节失衡为临床特征。AKI在儿童的发病率逐年升高,住院儿童及成人AKI发病率的增加与其病死率密切相关。继续依赖血肌酐和尿量去诊断AKI导致不能早期提供有效的治疗和支持性的干预措施去阻止和缓解AKI的发生。最近10年实验研究重点在发现和验证在肾功能改变之前识别AKI及有助于鉴别诊断的新的生物标志物。

Abstract

Acute kidney injury (AKI) is characterized by a reversible increase in blood concentration of creatinine and nitrogenous waste products and by the inability of the kidney to regulate fluid and electrolyte homeostasis appropriately. AKI in hospitalized patients is independently associated with increased morbidity and mortality in pediatric and adult populations. Continued reliance on serum creatinine and urine output for the diagnosis of AKI has resulted in an inability to provide successful therapeutic and supportive interventions to prevent and mitigate AKI. Research efforts over the last decade have foused on the discovery and validation of novel biomarkers to detect AKI prior to a change in kidney function and to make a differential diagnosis of AKI.

关键词

急性肾损伤 / 血肌酐 / 儿童

Key words

Acute kidney injury / Serum creatinine / Child

引用本文

导出引用
吴小川. 认识儿童急性肾损伤[J]. 中国当代儿科杂志. 2014, 16(4): 345-348 https://doi.org/10.7499/j.issn.1008-8830.2014.04.007
WU Xiao-Chuan. Recognizing pediatric acute kidney injury[J]. Chinese Journal of Contemporary Pediatrics. 2014, 16(4): 345-348 https://doi.org/10.7499/j.issn.1008-8830.2014.04.007

参考文献

[1] Bellomo R, Ronco C, Kellum JA, et al. Acute Dialysis Quality Initiative workgroup. Acute renal failure: Definition, outcome measures, animal models, fluid therapy and information technology needs: The Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group[J]. Crit Care, 2004, 8: R204-212.
[2] Bell M, Liljestam E, Granath F, et al. Optimal follow-up time after continuous renal replacement therapy in actual renal failure patients stratified with the RIFLE criteria[J]. Nephrol Dial Transplant, 2005, 20(2): 354-360.
[3] Maccariello E, Soares M, Valente C, et al. RIFLE classification in patients with acute kidney injury in need of renal replacement therapy[J]. Intensive Care Med, 2007, 33(4): 597-605.
[4] Ricci Z, Cruz D, Ronco C. The RIFLE criteria and mortality in acute kidney injury: A systematic review[J]. Kidney Int, 2008, 73(5): 538-546.
[5] Akcan-Arikan A, Zappitelli M, Loftis LL, et al. Modified RIFLE criteria in critically ill children with acute kidney injury[J]. Kidney Int, 2007, 71(10): 1028-1035.
[6] Devarajan P. Emerging urinary biomarkers in the diagnosis of acute kidney injury[J]. Expert Opin Med Diagn, 2008, 2(4): 387-398.
[7] Mishra J, Dent C, Tarabishi R, et al. Neutrophil gelatinase-associated lipocalin (NGAL) as a biomarker for acute renal injury after cardiac surgery[J]. Lancet, 2005, 365(9466): 1231-1238.
[8] Parikh CR, Mishra J, Thiessen-Philbrook H, et al. Urinary IL-18 is an early predictive biomarker of acute kidney injury after cardiac surgery[J]. Kidney Int, 2006, 70(1): 199-203.
[9] Portilla D, Dent C, Sugaya T, et al. Liver fatty acid-binding protein as a biomarker of acute kidney injury after cardiac surgery[J]. Kidney Int, 2008, 73(4): 465-472.
[10] Bennett M, Dent CL, Ma Q, et al. Urine NGAL predicts severity of acute kidney injury after cardiac surgery: a prospective study[J]. Clin J Am Soc Nephrol, 2008, 3(3): 665-673.
[11] Dent CL, Ma Q, Dastrala S, et al. Plasma neutrophil gelatinase-associated lipocalin predicts acute kidney injury, morbidity and mortality after pediatric cardiac surgery: a prospective uncontrolled cohort study[J]. Crit Care, 2007, 11(6): R127.
[12] Krawczeski CD, Woo JG, Wang Y, et al. Neutrophil gelatinase-associated lipocalin concentrations predict development of acute kidney injury in neonates and children after cardiopulmonary bypass[J]. J Pediatr, 2011, 158(6): 1009-1015.
[13] Endre ZH, Pickering JW, Walker RJ, et al. Improved performance of urinary biomarkers of acute kidney injury in the critically ill by stratification for injury duration and baseline renal function[J]. Kidney Int, 2011, 79(10): 1119-1130.
[14] Anochie IC, Eke FU. Acute renal failure in Nigerian children: Port Harcourt experience[J]. Pediatr Nephrol, 2005, 20(11): 1610-1614.
[15] Olowu WA, Adelusola KA. Pediatric acute renal failure in southwestern Nigeria[J]. Kidney Int, 2004, 66(4): 1541-1548.
[16] KDIGO AKI Work Group: KDIGO clinical practice guideline for acute kidney injury[J]. Kidney Int Suppl, 2012, 2: 1-138.
[17] Jenik AG, Ceriani Cernadas JM, Gorenstein A, et al. A randomized, double-blind, placebo-controlled trial of the effects of prophylactic theophylline on renal function in term neonates with perinatal asphyxia[J]. Pediatrics, 2000, 105(4): 849-853.
[18] Bakr AF. Prophylactic theophylline to prevent renal dysfunction in newborns exposed to perinatal asphyxia-a study in a developing country[J]. Pediatr Nephrol, 2005, 20(9): 1249-1252.
[19] Bhat MA, Shah ZA, Makhdoomi MS, et al. Theophylline for renal function in term neonates with perinatal asphyxia: a randomized, placebo-controlled trial[J]. J Pediatr, 2006, 149(2): 180-184.
[20] Bellomo R, Chapman M, Finfer S, et al. Low-dose dopamine in patients with early renal dysfunction: a placebo-controlled randomised trial. Australian and New Zealand Intensive Care Society (ANZICS) Clinical Trials Group[J]. Lancet, 2000, 356(9248): 2139-2143.
[21] Kellum JA, M Decker J. Use of dopamine in acute renal failure: a meta-analysis[J]. Crit Care Med, 2001, 29(8): 1526-1531.
[22] Lauschke A, Teichgraber UK, Frei U, et al. Low-dose dopamine worsens renal perfusion in patients with acute renal failure[J]. Kidney Int, 2006, 69(9): 1669-1674.
[23] Marik PE. Low-dose dopamine: a systematic review[J]. Intensive Care Med, 2002, 28(7): 877-883.
[24] Friedrich JO, Adhikari N, Herridge MS, et al. Meta-analysis: low-dose dopamine increases urine output but does not prevent renal dysfunction or death[J]. Ann Intern Med, 2005, 42(7): 510-524.
[25] Landoni G, Biondi-Zoccai GG, Tumlin JA, et al. Beneficial impact of fenoldopam in critically ill patients with or at risk for acute renal failure: a meta-analysis of randomized clinical trials[J]. Am J Kidney Dis, 2007, 49(1): 56-68.
[26] Weston CE, Feibelman MB, Wu K, et al. Effect of oxidant stress on growth factor stimulation of proliferation in cultured human proximal tubule cells[J]. Kidney Int, 1999, 56(4): 1274-1276.
[27] Chatterjee PK, Cuzzocrea S, Brown PA, et al. Tempol, a membrane-permeable radical scavenger, reduces oxidant stress-mediated renal dysfunction and injury in the rat[J]. Kidney Int, 2000, 58(2): 658-673.
[28] Lange C, Togel F, Ittrich H, et al. Administered mesenchymal stem cells enhance recovery from ischemia/reperfusion-induced acute renal failure in rats[J]. Kidney Int, 2005, 68(4): 1613-1617.
[29] Molitoris BA. Transitioning to therapy in ischemic acute renal failure[J]. J Am Soc Nephrol, 2003, 14(1): 265-267.
[30] Jo SK, Rosner MH, Okusa MD. Pharmacologic treatment of acute kidney injury: why drugs haven't worked and what is on the horizon[J]. Clin J Am Soc Nephrol, 2007, 2(2): 356-365.
[31] Metha RL, Pascual MT, Soroko S, et al. Diuretics, mortality and non-recovery of renal function in acute renal failure[J]. JAMA, 2002, 228(20): 2547-2553.
[32] Metnitz PG, Krenn CG, Steltzer H, et al. Effect of acute renal failure requiring renal replacement therapy on outcome in critically ill patients[J]. Crit Care Med, 2002, 30(9): 2051-2058.
[33] Askenazi DJ, Feig DI, Graham NM, et al. 1-5 year longitudinal follow-up of pediatric patients after acute renal failure[J]. Kidney Int, 2006, 69(1): 184-189.
[34] Rodriguez MM, Gomez A, Abitbol C, et al. Comparative renal histomorphometry: a case study of oliogonephropathy of prematurity[J]. Pediatr Nephrol, 2005, 20(7): 945-949.
[35] Abitbol CL, Bauer CR, Montane B, et al. Long-term follow-up of extremely low birth weight infants with neonatal renal failure[J]. Pediatr Nephrol, 2003, 18(9): 887-893.
[36] Polito C, Papale MR, LaManna AL. Long term prognosis of acute renal failure in the full term newborn[J]. Clin Pediatr (Phila), 1998, 37(6): 381-386.
[37] Kist-van Holthe JE, Van Zwet JM, Brand R, et al. Prospective study of renal insufficiency after bone marrow transplantation[J]. Pediatr Nephrol, 2002, 17(12): 1032-1037.

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