臨牀透析 Vol.29 No.11(2-2)


特集名 わが国におけるAKI診療の現状と課題
題名 [各論]術後AKIの早期診断と治療
発刊年月 2013年 10月
著者 土井 研人 東京大学医学部附属病院集中治療部
著者 野入 英世 東京大学医学部附属病院血液浄化療法部
【 要旨 】 AKI(急性腎障害)は急性期入院症例の5%程度に合併する臓器障害であり,院内死亡や入院期間延長と有意に関連するのみならず,慢性腎臓病(CKD)への移行・進展に対しても大きく寄与しうる予後不良の疾患である.周術期においてAKI発症頻度は高く,とくに心臓血管手術術後症例ではさらに頻度が上昇し,予後も不良となる.術後AKIのリスク因子の同定,早期診断バイオマーカーの性能評価が精力的に行われているが,今後は得られた知見をもとに画期的な術後AKI治療戦略の開発が進むことが望まれる.
Theme Current trends and issues for medical management of acute kidney injury in Japan
Title Early diagnosis and treatment of postoperative acute kidney injury
Author Kent Doi Department of Emergency and Critical Care Medicine, The University of Tokyo
Author Eisei Noiri Department of Hemodialysis and Apheresis, The University of Tokyo
[ Summary ] The incidence of acute kidney injury (AKI) generally accounts for 5 % of all acute care hospitalizations. AKI often leads to serious morbidity, associated with greater length of hospital stay, high risk of hospital mortality, and increased risk of incidents, as well as progressive chronic kidney disease. AKI occurs more frequently in perioperative settings especially those related to cardiac or vascular surgery. At this time, identification of the risk factors for postoperative AKI and evaluation of new AKI biomarkers for early diagnosis are possible. Based on the findings obtained, further investigation is necessary to develop a novel therapeutic strategy for postoperative AKI treatment.
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