2024 年第 1 期 第 19 卷

急性肾损伤的流行病学和早期诊断及治疗进展

Research progress on epidemiology, early diagnosis, and treatment of acute kidney injury

作者：王文蕾 沈清

英文作者：Wang Wenlei Shen Qing

单位：重庆医科大学附属第一医院肾内科，重庆400042

英文单位：Department of Nephrology the First Affiliated Hospital of Chongqing Medical University Chongqing 400042 China

关键词：急性肾损伤；流行病学；肾脏替代治疗；生物标志物

英文关键词：Acutekidneyinjury;Epidemiology;Renalreplacementtherapy;Biomarker

• 摘要：

• 急性肾损伤（AKI）是一种常见的临床综合征，主要表现为血清肌酐和尿素氮等升高以及水、电解质、酸碱平衡紊乱。我国流行病学将AKI分为社区获得性AKI和医院获得性AKI，初步明确了其发病率、死亡率、病因以及地域分布特点。AKI与死亡率的增加独立相关，但目前对于AKI的诊治仍然面临诸多难题。新型生物标志物预测早期AKI比血清肌酐和尿量更为敏感，可能有助于识别AKI进展的高风险群体，并指导AKI的临床管理。肾脏替代治疗在治疗AKI时的模式、剂量、时机均可对患者预后产生影响。此外，靶点治疗为AKI的临床治疗开启了新方向。在本文中，我们对AKI的流行病学、生物标志物以及治疗策略相关研究进展进行综述，以期为后续临床研究提供新思路。

• Acute kidney injury (AKI) is a common clinical syndrome, which is mainly characterized by the increase of serum creatinine and urea nitrogen, and the disorder of water, electrolyte and acid-base balance. AKI is divided into community-acquired AKI and hospital-acquired AKI in the epidemiology of China, and its incidence, mortality, etiology and regional distribution characteristics have been preliminarily clarified. AKI is independently associated with higher mortality, but there are still many problems in the diagnosis and treatment of AKI. Novel biomarkers are more sensitive than serum creatinine and urine volume in predicting early AKI, which may help to identify groups at high risk of AKI progression and guide clinical management of AKI. The mode, dose and timing of renal replacement therapy in the treatment of AKI can affect the prognosis of patients. In addition, targeted therapy opens a new direction for the clinical treatment of AKI. In this article, we review the research progress on the epidemiology, biomarkers and treatment strategies of AKI, in order to provide new ideas for subsequent clinical research.