文档仅供参考,不能作为科学依据,请勿模仿;如有不当之处,请联系网站或本人删除。目 的• 更新观念,提高认识;• 了解新指标,早期做诊断;• 应用新技术,早期做干预。 文档仅供参考,不能作为科学依据,请勿模仿;如有不当之处,请联系网站或本人删除。流行病学• It occurs in – 5%of all hospitalized patients and – 35% of those in intensive care units • Mortality is high:• up to 75–90% in patients with sepsis• 35–45% in those without 文档仅供参考,不能作为科学依据,请勿模仿;如有不当之处,请联系网站或本人删除。Median hospital length of stay (LOS) stratified by single acute organ system dysfunction (AOSD), including acute renal failure (ARF). 文档仅供参考,不能作为科学依据,请勿模仿;如有不当之处,请联系网站或本人删除。Acute Kidney InjuryAcute Renal Failure 文档仅供参考,不能作为科学依据,请勿模仿;如有不当之处,请联系网站或本人删除。ARF 定义的提出•the first description of ARF termed ischuria renalis, was by William Heberden in 1802 ;•named acute Bright’s disease, was well described in William Osler’s early works (1909) ;•During World War I the syndrome was named ‘War Nephritis’ ;•World War II, Bywaters and Beall , crush syndrome ;•Homer W.Smith who is credited with the introduction of the term ‘ARF’ in 1951.•BY 2002, at least 35 definitions in the literature 。急性肾衰竭是指肾小球滤过功能在数小时至数周内迅速降低而引起的以水、电解质和酸碱平衡失调以及含氮废物蓄积为主要特征的一组临床综合症。 文档仅供参考,不能作为科学依据,请勿模仿;如有不当之处,请联系网站或本人删除。RIFLE 分级2002 年急性透析质量倡议组 (ADQI) 制定了 ARF 的 RIFLE 分级诊断标准。Bellomo R, et al. Crit Care 2004;8:R204-R212 文档仅供参考,不能作为科学依据,请勿模仿;如有不当之处,请联系网站或本人删除。AKI 定义提出的必要性Chertow 等研究表明 , 血肌酐上升 26.5μmol/L 可使病死率上升 4.1 倍。大量临床研究显示 , 肾功能轻度损伤即可导致 AKI 发病率...