Perioperative acute renal failure.

Mahon P; Shorten G

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Perioperative acute renal failure.

机译：围手术期急性肾功能衰竭。

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PURPOSE OF REVIEW: Recent biochemical evidence increasingly implicates inflammatory mechanisms as precipitants of acute renal failure. In this review, we detail some of these pathways together with potential new therapeutic targets. RECENT FINDINGS: Neutrophil gelatinase-associated lipocalin appears to be a sensitive, specific and reliable biomarker of renal injury, which may be predictive of renal outcome in the perioperative setting. For estimation of glomerular filtration rate, cystatin C is superior to creatinine. No drug is definitively effective at preventing postoperative renal failure. Clinical trials of fenoldopam and atrial natriuretic peptide are, at best, equivocal. As with pharmacological preconditioning of the heart, volatile anaesthetic agents appear to offer a protective effect to the subsequently ischaemic kidney. SUMMARY: Although a greatly improved understanding of the pathophysiology of acute renal failure has offered even more therapeutic targets, the maintenance of intravascular euvolaemia and perfusion pressure is most effective at preventing new postoperative acute renal failure. In the future, strategies targeting renal regeneration after injury will use bone marrow-derived stem cells and growth factors such as insulin-like growth factor-1.

机译：审查目的：最近的生化证据越来越多地表明炎症机制是急性肾衰竭的诱因。在这篇综述中，我们详细介绍了其中一些途径以及潜在的新治疗靶标。最近的发现：嗜中性粒细胞明胶酶相关的脂质运载蛋白似乎是肾脏损伤的敏感，特异和可靠的生物标志物，可能预示着围手术期肾脏的预后。为了评估肾小球滤过率，胱抑素C优于肌酐。绝对没有药物能有效预防术后肾衰竭。 fenoldopam和心房利钠肽的临床试验充其量是模棱两可的。与心脏的药理学预处理一样，挥发性麻醉剂似乎对随后的缺血性肾脏具有保护作用。总结：尽管对急性肾衰竭的病理生理学的极大改善提供了更多的治疗靶点，但维持血管内葡萄膜血流和灌注压力对预防新的术后急性肾衰竭最为有效。将来，针对损伤后肾脏再生的策略将使用骨髓衍生的干细胞和生长因子，如胰岛素样生长因子-1。

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《Current opinion in anaesthesiology》 |2006年第3期|共7页
作者
Mahon P; Shorten G;
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正文语种 eng
中图分类外科手术学;
关键词
Kidney Failure; Acute; Renal; Recent; Therapeutic; Injury inflicted to the body by an external force; 肾功能衰竭; 急性;

机译：Kidney Failure;Acute;Renal;Recent;Therapeutic;Injury inflicted to the body by an external force;肾功能衰竭;急性;

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1. Perioperative acute renal failure. [J] . Mahon P, Shorten G Current opinion in anaesthesiology . 2006,第3期

机译：围手术期急性肾功能衰竭。
2. Atrial natriuretic factor in oliguric acute renal failure. Anaritide Acute Renal Failure Study Group. [J] . Lewis J, Salem MM, Chertow GM, American Journal of Kidney Diseases: The official journal of the National Kidney Foundation . 2000,第4期

机译：心房利钠因子在少尿性急性肾衰竭中的作用。阿那立肽急性肾衰竭研究组。
3. Infrarenal aortic-clamping after renal ischaemia aggravates acute renal failure. [J] . Yeung KK, Richir M, Hanrath P, European journal of clinical investigation . 2011,第6期

机译：肾缺血后肾下主动脉夹闭加重急性肾衰竭。
4. Prognostic implications of serum HSP60 levels in patients with acute heart failure. [C] . Bonanad Clara, Nunez Julio, Chaustre Fabian, World Congress on Heart Disease . 2011

机译：血清HSP60水平对急性心脏衰竭患者的预后意义。
5. Blood-Pressure Reduction is Associated With Worsening in Renal Function but Does Not Prevent Successful Decongestion in Patients Treated for Acute Decompensated Heart Failure. [D] . Kula, Alexander James. 2015

机译：降压与肾功能恶化有关，但不能阻止接受急性代偿性心力衰竭治疗的患者成功消退。
6. Epidermal growth factor enhances renal tubule cell regeneration and repair and accelerates the recovery of renal function in postischemic acute renal failure. [O] . H D Humes, D A Cieslinski, T M Coimbra, 1989

机译：表皮生长因子增强缺血性急性肾衰竭后肾小管细胞的再生和修复并加速肾功能的恢复。
7. International dialysis aid in earthquakes and other disasters11This manuscript represents the result of one of the major initiatives of the ISN Commission on Acute Renal Failure. As in the report describing the Banff schema for renal allograft pathology also published recently in this journal (44:411–422, 1993), the authors represent a combination of Commission members and collaborators, all of whom played a significant role in the project. The members of the ISN Commission on Acute Renal Failure are: K. Solez (Chairman), Edmonton, Canada; R. Balaban, Bethesda, USA; E. Carafoli, Zurich, Switzerland; H. Eliahou, Tel-Hashomer, Israel; F. Epstein, Boston, USA; R. Hakim, Nashville, USA; N. Honda, Tokyo, Japan; D. Humes, Ann Arbor, USA; N. Lameire, Gent, Belgium; L. Mandei, Durham, USA; and M. Mihatsch, Basel, Switzerland. The purpose of the ISN Commission on Acute Renal Failure is “to represent the highest possible level of scientific investigation in acute renal failure and to bring together nephrologists and physicians, and scientists of other relevant disciplines”. (Kidney Int 38:1244, 1990). [O] . Solez Kim, Bihari David, Collins Allan J., 1993

机译：地震和其他灾害中的国际透析援助11该手稿是ISN急性肾衰竭委员会一项重大举措的成果。正如最近在该杂志上发表的描述Banff肾脏同种异体移植病理学方案的报告（44：411–422，1993）中一样，作者代表了委员会成员和合作者的组合，他们在该项目中均发挥了重要作用。 ISN急性肾功能衰竭委员会的成员是：加拿大埃德蒙顿市的K. Solez（主席）；美国贝塞斯达R.Balaban; E. Carafoli，瑞士苏黎世；以色列Tel-Hashomer的H. Eliahou； F.爱泼斯坦，美国波士顿； R. Hakim，美国纳什维尔；日本东京本田N. D. Humes，美国安娜堡；比利时根特市N.Lameire； L. Mandei，美国达勒姆；和瑞士巴塞尔的M. Mihatsch。 ISN急性肾功能衰竭委员会的目的是“代表急性肾衰竭的最高科学调查水平，并使肾病学家和内科医生以及其他相关学科的科学家聚集在一起”。（Kidney Int 38：1244，1990）。
8. CRRT versus IHD in Acute Renal Failure. Abstract, Executive Summary, Final Reportand Appendix A [R] . Mehta, R. L. 1996

机译：急性肾功能衰竭时CRRT与IHD的关系。摘要，执行摘要，最终报告和附录a.

Perioperative acute renal failure.

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