臨牀透析 Vol.29 No.11(2-5)


特集名 わが国におけるAKI診療の現状と課題
題名 ［各論］感染症によるAKIの早期発見と治療法
発刊年月 2013年 10月
著者 安田 日出夫 浜松医科大学第一内科
【 要旨 】 感染症，とくに敗血症に伴う急性腎障害（acute kidney injury；AKI）は予後不良であり，予防や早期発見・早期治療が求められている．近年，新規尿中バイオマーカーが注目されており，そのなかで尿中liver-type fatty acid-binding protein（L-FABP）は本邦の保険診療で用いることが可能である．予防および治療には，early goal-directed therapyが有用であることが知られており，集中治療室での基本的な治療となっているが，体液過剰はAKIの予後不良因子であり，輸液過多には気をつける必要がある．適切な腎機能代替療法は予後を改善する可能性がある．
Theme Current trends and issues for medical management of acute kidney injury in Japan
Title Biomarkers and treatments for acute kidney injury induced by infections/sepsis
Author Hideo Yasuda First Department of Medicine, Hamamatsu University School of Medicine
[ Summary ] Acute kidney injury (AKI) with infection or sepsis has unfavorable outcomes. Prevention and early detection followed by interventions must be provided emergently. The use of novel urinary biomarkers such as liver-type fatty acid-binding proteins (L-FABP) has been developed for early detection and prognosis of AKI induced by sepsis. Resuscitation in intensive care units is based on early goal-directed therapy, leading to prevention of AKI. The avoidance of volume overload and proper intervention through renal replacement therapy have the potential to improve the prognoses for patients suffering from AKI induced by sepsis.
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