臨牀透析 Vol.35 No.6(2)


特集名 AKI診療のエビデンスと課題
題名 AKIの疫学とリスク因子
発刊年月 2019年 06月
著者 迫 恵輔 金沢大学附属病院腎臓内科
著者 古市 賢吾 金沢医科大学病院腎臓内科
著者 和田 隆志 金沢大学附属病院腎臓内科
【 要旨 】 近年,急性腎障害(AKI)の発症率は増加傾向にある.AKIは慢性腎臓病や末期腎不全のリスク因子としてだけでなく,生命予後因子としても重要である.2004年以降,RIFLE分類・AKIN分類・KDIGO分類とAKIの診断基準が提唱された.以後,AKIについて多くの報告が集積され,2016年には本邦初のAKIガイドラインである「AKI(急性腎障害)診療ガイドライン2016」が刊行された.このガイドラインでは,院内発症AKIと院外発症AKIについて区別することを指摘している.疫学研究では,多国間共同研究であるthe 0by25 initiativeがスタートし,発展途上国を含めたAKIの予防・対策が重要視されている.また,最近ではAKIの再発といった新たなリスク因子が報告されており,AKI後のフォローアップも重要な課題となっている.
Theme Evidence and issue for clinical practice of acute kidney injury
Title Epidemiology and risk factors for AKI
Author Keisuke Sako Division of Nephrology, Kanazawa University Hospital
Author Kengo Furuichi Division of Nephrology, Kanazawa Medical University Hospital
Author Takashi Wada Division of Nephrology, Kanazawa University Hospital
[ Summary ] In recent years, the incidence of acute kidney injury (AKI) has been increasing. AKI is important not only as a risk factor for chronic kidney disease and end-stage kidney disease but also as a life prognostic factor. Since 2004, RIFLE classification, AKIN classification, and KDIGO classification have been proposed as diagnostic criteria of AKI sequentially. Thereafter, many reports about AKI were published. In 2016, "The Japanese Clinical Practice Guideline for acute kidney injury 2016", which is the first Japanese AKI guideline, was published. The guideline showed that hospital-acquired AKI and community-acquired AKI are dif ferent. Through epidemiological research and multilateral collaborative research, the 0by25 initiative*, has started. Prevention and countermeasures of AKI including those in developing countries are regarded as important. Recently, new risk factors such as recurrent AKI have been reported and follow-up after AKI is also an important subject.

* The 0by25 initiative is an ambitious goal launched by the International Society of Nephrology (ISN) which aims to eliminate preventable deaths from AKI worldwide by 2025.
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