臨牀透析 Vol.29 No.11(2-1)


特集名 わが国におけるAKI診療の現状と課題
題名 ［各論］AKIの定義と病期分類
発刊年月 2013年 10月
著者 濵田 佳寿 高知大学医学部内分泌代謝・腎臓内科
著者 松本 竜季 高知大学医学部内分泌代謝・腎臓内科
著者 堀野 太郎 高知大学医学部内分泌代謝・腎臓内科
著者 寺田 典生 高知大学医学部内分泌代謝・腎臓内科
【 要旨 】 2012年3月，KDIGO（Kidney Disease：Improving Global Outcomes）がRIFLE（Risk，Injury，Failure，Loss，End-stage kidney disease）分類およびAKIN（Acute Kidney Injury Network）分類をまとめた形でAKI（acute kidney injury）の定義を改定し，AKIガイドラインを作成した．その特徴としては，AKIN分類同様に，48時間以内での0.3mg/dL以上の血清クレアチニン（Cr）上昇をAKIと定義している点に加え，RIFLE分類の7日間以内の血清Crの1.5倍以上の上昇が加わっている点である．今回，今までのAKIの定義の流れや改変されたKDIGOガイドラインについて簡単に述べる．
Theme Current trends and issues for medical management of acute kidney injury in Japan
Title Definition and staging of AKI
Author Kazu Hamada Department of Endocrinology, Metabolism and Nephrology, Kochi University School of Medicine
Author Tatsuki Matsumoto Department of Endocrinology, Metabolism and Nephrology, Kochi University School of Medicine
Author Taro Horino Department of Endocrinology, Metabolism and Nephrology, Kochi University School of Medicine
Author Yoshio Terada Department of Endocrinology, Metabolism and Nephrology, Kochi University School of Medicine
[ Summary ] In March 2012, the outlines known as : KDIGO (Kidney Disease : Improving Global Outcomes) revised the definition of AKI (acute kidney injury) and created the AKI guidelines which summarized RIFLE (Risk, Injury, Failure, Loss, End-stage kidney disease) and AKIN (Acute Kidney Injury Network) classifications. The pivotal points of this guideline are described as the follows : AKI is defined as an increase of more than 0.3 mg/dL in serum creatinine (Cr) levels within 48 hours, the same as the AKIN classification. Furthermore this definition included an increase of more than 1.5 times in serum Cr within 7 days of RIFLE classification. The history of the definition of AKI and the modified KDIGO guidelines are outlined.
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