mwwXaiv lus
Tsev / Kev paub / Ntsiab lus

Kev paub

Kev Saib Xyuas Zoo Rau Mob raum Mob: Kev Paub Txog Tam Sim No Thiab Cov Lus Qhia Yav Tom Ntej

Feb 20, 2022

Kathleen D. Liu1,2, Lui G. Forni3, Michael Heung 4, et al


Mob raum mob (AKI) thiabmob raum mob (AKD) yog cov teeb meem tshwm sim hauv cov neeg mob hauv tsev kho mob thiab cuam tshuam nrog cov txiaj ntsig tsis zoo. Txawm hais tias kev pom zoo cov txheej txheem tau txhim kho kev saib xyuas cov neeg mob nrogAKIthiabAKD, kev taw qhia txog kev ntsuas zoo hauv kev saib xyuas cov neeg mob tom qab ib ntus ntawmAKIlos yogAKDyog txwv. Piv txwv li, ob peb tus neeg mob tau txais kev soj ntsuam tom qab kuaj lub raum ua haujlwm lossis tom qab-AKIlos yogAKDsaib xyuas los ntawm nephrology lossis lwm tus kws kho mob. Tsis ntev los no, Tus Kab Mob Zoo Tshaj Plaws tau tsim cov lus pom zoo hais txog kev txhim kho cov hom phiaj zoo rau cov neeg mob nrogAKIlos yogAKDtshwj xeeb qhia txog kev siv zog txog kev ua tau zoo thiab kev nyab xeeb ntawm kev saib xyuas tom qab tawm hauv tsev kho mob tom qab ib ntus ntawmAKIlos yogAKD. Lub hom phiaj yog siv cov kev ntsuas no los txheeb xyuas cov hauv kev rau kev txhim kho uas yuav ua rau muaj txiaj ntsig zoo. Peb pom zoo kom cov kev kho mob kom muaj nuj nqis ntawm cov neeg mob uas xav tau thiab tau txais kev saib xyuas tom qab qhov ntsuas.AKIlos yogAKDpw hauv tsev kho mob. Kev siv zog thiab kev tsim nyog ntawm kev saib xyuas yuav tsum nyob ntawm tus neeg mob tus yam ntxwv, qhov hnyav, ntev, thiab chav kawm ntawmAKIntawmAKD, thiab yuav tsum hloov zuj zus raws li cov ntaub ntawv pov thawj-raws li cov txheej txheem tshwm sim. Cov ntsuas zoo rau cov neeg mob tso tawm nrog kev lim ntshav xav tauAKIlos yogAKDyuav tsum sib txawv ntawm qhov kawg-stage kev ntsuas kab mob raum. Tsis tas li ntawd, yuav tsum muaj cov cim qhia tau zoo rau cov uas tseem xav tau kev lim ntshav hauv qhov chaw kho mob tom qabAKIlos yogAKD. Muab cov ntaub ntawv tsis pub dhau los qhia txog kev saib xyuas cov neeg mob tom qab ib ntus ntawm AKI lossis AKD, muaj lub sijhawm txaus los tsim cov kev ntsuas zoo thiab muaj peev xwm txhim kho cov neeg mob thiab cov txiaj ntsig tau zoo. Qhov kev tshuaj xyuas no yuav muab cov pov thawj tshwj xeeb-raws li thiab cov kws tshaj lij kev xav-raws li kev taw qhia rau kev saib xyuas cov neeg mob nrogAKIlos yogAKDtom qab tsev kho mob tawm.

Hu rau:joanna.jia@wecistanche.com/ WhatsApp: 008618081934791

cistanche can treat kidney disease

Mob raum raug mob (AKI) yog ib qho kev kho mob uas tshwm sim thiab tseem cuam tshuam nrog kev mob hnyav ntxiv, kev tuag, thiab tus nqi ntawm kev saib xyuas1,2 txawm tias cov ntawv tshaj tawm tsis ntev los no qhia tau hais tias AKI tus nqi thiab qhov hnyav yuav raug txo los ntawm kev siv cov khoom tu.3–5Lub raumKab Mob Txhim Kho Ntiaj Teb Cov txiaj ntsig AKI ua haujlwm thawj zaug tau qhia txog lub tswv yim ntawm kab mob raum mob hnyav (AKD) los qhia txog qhov tseem ceeb ntawm

ntevraumdysfunction (nyob rau hauv lub xub ntiag los yog tsis muajAKI) uas yuav tshwm sim ua ntej tus neeg mob ua tau raws li 90-hnub cov txheej txheem xav tau rau cov txheej txheem kuaj mob ntevraumKab mob (CKD).6 Tom qab ntawd, Tus Kab Mob Ntshav Qab Zib Zoo Tshaj Plaws (ADQI) tau npaj cov txheej txheem rauAKD(Daim duab 1).7 Vim tias kev saib xyuas ntawm AKI tsis yog tus qauv zoo, nws yuav tsum tsis txhob xav tsis thoob tias kev saib xyuas cov neeg mob AKD tseem tsawg dua thiab tsis muaj cov lus qhia zoo thiab cov lus qhia saib xyuas neeg mob. Lub Koom Haum Saib Xyuas Kev Noj Qab Haus Huv Kev Noj Qab Haus Huv yog ntau tus kws tshaj lij, koom nrog kev pom zoo sib koom ua ke uas txheeb xyuas thaj chaw tseem ceeb hauv thaj chaw ntawm AKI thiab tsim cov lus pom zoo hais txog kev kho mob thiab kev tshawb fawb. Tsis ntev los no, ADQI XXII tau ntsib los tsim cov hom phiaj kev txhim kho kom zoo rau AKI thiab AKD.8 Ntawm no, peb yuav sib tham txog cov hauv kev los tsim kev ntsuas zoo hauv cov neeg uas muajAKIlossis AKD tom qab tawm hauv tsev kho mob.

Figure 1. The spectrum of acute kidney injury (AKI), acute kidney disease (AKD), and chronic kidney disease (CKD). Acute kidney injury, AKD, and CKD can form a spectrum of diagnoses in which the initial kidney injury can potentially lead to the development of CKD. Acute kidney injury describes a process of damage, loss of kidney function, or both for 7–90 days after exposure to an AKI initiating event. For patients with preexisting CKD, the AKI event can be superimposed on CKD, with AKD existing on a background of CKD. Patients who experience AKD with preexisting CKD are probably at high risk for kidney disease progression.

Nqe Lus Qhia 1: Txhawm rau txhim kho kev saib xyuas cov neeg mob nrog AKI lossis AKD, Cov Kev Kho Mob yuav tsum tau ntsuas qhov feem pua ​​​​ntawm cov neeg mob uas xav tau thiab tau txais kev saib xyuas raws li lawv qhov Index AKI lossis AKD Tsev Kho Mob

Muab qhov tseem ceeb morbidity thiab morbidity txuam nrogAKI, kev soj ntsuam kev kho mob muaj txiaj ntsig yog qhov xav tau, txawm hais tias cov ntaub ntawv pov thawj hauv cov ntsiab lus ntawm kev ntsuas kev ntsuas tau zoo tsis tshua muaj.9 Txawm tias muaj mob hnyav AKI, cov neeg mob tsis tshua tau txais kev soj ntsuam nephrology; Hauv kev tshawb fawb rov qab los ntawm Asmeskas cov qub tub rog, tsuas yog 17 ntawm 57 cov kev kawm nrog theem 3 AKI raug xa mus rau kev soj ntsuam.10 Txawm li cas los xij, txawm tias tsis muaj cov ntaub ntawv muaj zog los txhawb lawv txoj kev ntseeg, feem ntau cov kws kho mob nephrologist thiab cov kws kho mob ntseeg tias kev soj ntsuam. tom qab ib ntu ntawm AKI los yogAKDyog ib qho tseem ceeb.11 Ua thawj kauj ruam, cov kab ke kho mob yuav tsum tau txiav txim siab qhov feem ntawm cov neeg mob hauv tsev kho mob uas muajAKIlos yogAKDnrog rau tus lej uas tau txais kev saib xyuas tom qab tso tawm. Thaum cov lej hauv qab tau tsim, lawv tuaj yeem ua raws li qhov ntsuas tau zoo. Qhov no yuav tso cai rau cov txheej txheem kho mob txhawm rau txheeb xyuas cov teeb meem rau kev soj ntsuam kom tsim nyog thiab yuav ua li cas zoo tshaj kom ua tiav qhov kev soj ntsuam tsim nyog hauv 100 feem pua ​​​​ntawm cov neeg mob.



Raws li tau tham tom qab, hom thiab kev siv zog ntawm kev soj ntsuam yuav nyob ntawm tus neeg mob tus yam ntxwv thiab qhov hnyav ntawm AKI lossis AKD. Nyob ntawm cov txheej txheem hauv zos, nws yuav yog qhov ua tau zoo tshaj plaws los ua kom muaj kev txhim kho kom zoo. Qhov no tuaj yeem ua tau los ntawm cov cuab yeej sau cov ntaub ntawv loj los saib cov kev coj ua thoob plaws hauv lub cev, tab sis nws yuav yooj yim tshaj plaws los pib taug qab cov neeg mob pom los ntawm cov kws kho mob nephrology uas tau txais kev kho lub raum hloov thaum nkag; systems yuav tsum nrhiav tus qauv uas ua haujlwm rau lawv thiab tsim rau nws. Siv cov txheej txheem txhim kho kom zoo, cov teeb meem rau kev saib xyuas tom qab yuav tsum raug txheeb xyuas thiab kho. Yog tias qhov feem pua ​​​​ntawm cov neeg tau txais kev saib xyuas kom raug twb siab lawm, lossis raws li qhov kev faib ua feem no nce, kev txhim kho kom zoo tuaj yeem tsom mus rau cov neeg AKI thiab AKD tsis tshua muaj zog. Ntxiv Daim Ntawv Ntxiv Ntxiv A muab ib qho piv txwv ntawm cov txheej txheem no tuaj yeem ua haujlwm li cas.


Nqe Lus 2: Kev siv zog thiab kev tsim nyog ntawm kev soj ntsuam yog nyob ntawm tus neeg mob tus yam ntxwv zoo li qhov hnyav, ntev, thiab chav kawm ntawm AKI

Muab cov neeg mob coob zuj zus tuaj nrog AKI thiab AKD hnyav thiab cov teeb meem kev ua haujlwm hauv nephrology, nws yog ib qho tseem ceeb uas yuav tsum tau saib xyuas cov neeg mob uas xav tau kev soj ntsuam nephrology. Txawm tias nyob rau hauv pab pawg neeg mob uas muaj AKI hnyav tshaj plaws, kev soj ntsuam yog qhov zoo tshaj plaws. Hauv ib pawg ntawm cov neeg mob AKI tom qab kev phais mob plawv, tsuas yog 66 ntawm 359 tau txais kev soj ntsuam nephrology nyob rau hauv thawj xyoo tom qab phais (18 feem pua), txawm tias 54 feem pua ​​​​ntawm cov pab pawg tau txais kev kho lub raum nyob rau lub sijhawm postoperative thaum ntxov.12 Feem ntau ntawm pab pawg no zoo kawg nkaus yuav tsum tau txais kev soj ntsuam hauv nephrology-tsom ntsoov, ntau qhov kev qhuab qhia, xws li kev mob siab rau tom qab-AKI lossis AKD lub tsev kho mob, qhov twg tus kws kho mob nephrologist tuaj yeem koom tes nrog cov kws kho mob koom nrog (pharmacists, dietitians, thiab social workers) thiab kev saib xyuas thawj zaug. Txawm li cas los xij, kev soj ntsuam kom tsis tshua muaj mob AKI lossis AKD (piv txwv li, theem 1 AKI) yuav yog los ntawm cov kws kho mob uas tsis yog nephrology, suav nrog kev saib xyuas thawj zaug thiab lwm tus kws kho mob tshwj xeeb. Txawm hais tias qee thaj chaw lossis lub tebchaws tuaj yeem muab kev saib xyuas rau txhua tus neeg mob AKD, hauv lwm thaj chaw lossis lub tebchaws, tus naj npawb ntawm AKI thiab AKD cov neeg muaj sia nyob yuav muaj ntau dua li lub peev xwm rau cov neeg mob nephrology los muab kev saib xyuas. Xws li, cov tsis-nephrology Daim duab 1. Cov spectrum ntawm mob raum raug mob (AKI), mob raum mob (AKD), thiab mob raum mob (CKD). Cov kws kho mob raum mob muaj lub luag haujlwm tseem ceeb hauv kev saib xyuas mus sij hawm ntev ntawm cov neeg mob tom qab AKI thiab AKD. Kev ua raws li yuav tsum tau ua kom paub tseeb tias qhov kev rov zoo tag nrho tau tshwm sim raws li kev kuaj mob (piv txwv li, ntshav creatinine [SCr] thiab albuminuria) lossis kev saib xyuas cov sequelae ntawm AKI uas yuav cuam tshuam nrog kev loj hlob ntawm CKD (xws li, kub siab, kev loj hlob ntawm albuminuria. ).

Figure 2. Schematic for acute kidney injury (AKI) and acute kidney disease (AKD) follow-up. The figure displays a paradigm for the care of patients who experience AKI or AKD. Follow-up with nephrology and non-nephrology changes based on the duration and severity of AKI or AKD and varies along the horizontal axis. The timing and nature of follow-up are suggestions because there are limited data to inform this process. AKI-D, patients with dialysis-requiring AKI; CKD, chronic kidney disease; CV dx, cardiovascular disease; KAMPS, Kidney Function Check, Advocacy, Medications, Pressure, Sick Day Protocols; UA, urinalysis; neph appt, nephrology appointment; SCr, serum creatinine; Weight Assessment, Access, Teaching, Clearance, Hypotension, and Medications

Cov yam ntxwv ntawm tus neeg mob

Tus neeg mob noj qab haus huv uas tsis muaj kev sib kis uas tau ntsib qhov luv luv, ib ntus, thiab rov qab rov qab los ntawm AKI tsis xav tau kev soj ntsuam nephrology. Thaum SCr tau rov qab mus rau hauv lub hauv paus ntawm lub sijhawm tso tawm, kev ntsuas tus neeg mob ntawm 6-12 lub hlis yuav tsim nyog, tej zaum yog ib feem ntawm kev saib xyuas niaj hnub nrog tus kws kho mob thawj zaug, suav nrog kev kuaj ntshav raum yooj yim thiab tso zis. Thaum cov tib neeg muaj cov chav kawm AKI lossis AKD ntev dua, kev soj ntsuam hauv 3-6 lub hlis zoo li tsim nyog. Thaum muaj theem 3 AKI lossis AKD uas tsis rov qab los, kev soj ntsuam yuav tsum koom nrog cov kev pabcuam tshwj xeeb thaum lub sijhawm tsim nyog (Daim duab 2), 8 feem ntau nyob rau hnub ntawm kev tso tawm. Ntxiv nrog rau AKI lossis AKD qhov hnyav, cov neeg mob comorbidities yog qhov tseem ceeb rau kev txiav txim siab rau hom thiab kev siv zog ntawm kev rov qab los. Cov neeg mob uas muaj cov kab mob tseem ceeb, tshwj xeeb tshaj yog cov neeg muaj CKD tseem ceeb, yuav tsum nyob hauv kev saib xyuas nephrology ze.


To determine which post-AKI and AKD patients were at the highest risk for developing CKD, James and colleagues13 derived (Alberta) and validated (Ontario) a predictive model using data from over 12,500 Canadian admissions. Their risk score is composed of 6 graded components, including patient age, gender, baseline SCr, degree of albuminuria, peak AKI stage, and discharge SCr. The most heavily weighted variable in the score is discharge SCr; the most points are awarded for those who had an SCr of >1.3 mg/dl Txawm hais tias qhov qhab nia no tau raug lees paub los ntawm sab nraud hauv nws qhov kev tshaj tawm thawj zaug, nws tseem tsis tau raug lees paub hauv lwm cov koom haum thoob ntiaj teb lossis siv rau ntawm qhov dav.13


Txawm hais tias qhov qhab nia ntawm James thiab cov npoj yaig 13 muab qee cov lus qhia rau leej twg xav tau kev soj ntsuam kom ze rau cov teeb meem ntev ntawm AKI, cov neeg uas muaj cov teeb meem AKI tsis ntev los no xws li acid-base lossis electrolyte disorders, ntim ntau dhau, thiab lub raum tsis ua tiav. tseem yuav xav tau kev soj ntsuam nephrology ze.


Cov neeg mob uas muaj mob hnyav AKI zoo nkaus li tau txais txiaj ntsig zoo nrog cov kws kho mob tshwj xeeb, txawm hais tias cov uas twb tau txais kev kho mob nephrology ua ntej AKI lossis AKD tuaj yeem ua rau tsis zoo, tej zaum yuav cuam tshuam txog cov teeb meem ntawm cov kab mob raum ntev.14 Qhov tsis muaj CKD tsis txhais hais tias. tsis xav tau kev soj ntsuam. Kev nyeem ntawv tom qab AKI lossis AKD feem ntau tshwm sim rau cov neeg mob uas muaj kab mob pulmonary obstructive pulmonary los yog urinary tract infection, thiab cov neeg uas muaj ntim-overload los yog pulmonary edema.15,16 Cov ntaub ntawv tawm tshiab qhia tias cov neeg mob uas muaj cov ntaub ntawv AKI muaj kev pheej hmoo siab rau lub plawv tsis ua hauj lwm readmission.17 , 18

Table 1. Post–acute kidney injury and acute kidney disease kidney health care bundle

Lub Sijhawm Ua Raws Li

Tsis muaj pov thawj txog lub sijhawm zoo ntawm kev taug qab tom qab ib ntu ntawm AKI. Daim duab 2 qhia peb lub tswv yim schema hais txog lub sijhawm ntawm kev taug qab. Lub sijhawm pom zoo tsis tuaj yeem pom nyob rau hauv kev sib cais tab sis raug kho raws li tus neeg mob qhov mob thiab qhov hnyav ntawm AKI lossis AKD nrog rau kev xav tau kev soj ntsuam nrog nephrology lossis non-nephrology cov kws kho mob. Raws li kev soj ntsuam tau dhau los ua tus qauv, nws yuav tsim nyog rau cov kab ke kev noj qab haus huv los taug qab AKI thiab AKD cov txiaj ntsig tshwj xeeb ntawm 90 hnub lossis tej zaum ntawm 1 xyoos, nrog rau paub tseeb tias leej twg yog tus muab kev saib xyuas ntawd.

Cov ntaub ntawv tawm tshiab qhia tias kev ntsuas cov zis albumin rau creatinine piv (uACR) 3 lub hlis tom qab tso tawm hauv tsev kho mob tom qab ib ntus ntawm AKI tuaj yeem tso cai rau kev txheeb xyuas cov neeg mob uas muaj kev pheej hmoo siab tshaj plaws rau kev mob raum (txhais tau tias yog ib nrab ntawm qhov kwv yees glomerular filtration rate [GFR. ] lossis kev txhim kho ntawm cov kab mob raum kawg [ESRD]).raumKab mob kev loj hlob, qhov hnyav thiab theem ntawm AKI tsis yog. Nyob rau yav tom ntej, ntsuas uACR tom qab AKI tuaj yeem txuas rau cov kev cuam tshuam tshwj xeeb hauv cov neeg mob uas muaj kev pheej hmoo siab.19 Kev tshawb nrhiav yav tom ntej yuav tsum sim ua kom pom qhov cuam tshuam ntawm qhov cuam tshuam thaum ntxov piv rau kev rov qab los lig nrog rau lub peev xwm ntawm lwm cov biomarkers rau stratify mus sij hawm ntev. cov txiaj ntsig ntawm tus neeg mob.



Muaj peev xwm cuam tshuam

Zoo ib yam li lub sijhawm, AKI thiab AKD kev soj ntsuam xyuas yog nyob ntawm tus neeg mob comorbidities thiab qhov hnyav ntawm AKI lossis AKD. Vim hais tias cov txheeb ze tsis muaj pov thawj-raws li kev saib xyuas nyob rau hauv cov pej xeem no, yuav tsum muaj ib tug txheej txheem txhais ntawm kev saib xyuas raws li tsim nyog. Nephrologists yuav tsum txheeb xyuas cov neeg mob uas tau txais txiaj ntsig zoo tshaj plaws los ntawm kev soj ntsuam. Raws li cov ntaub ntawv pov thawj tsis pub tshaj tawm thiab cov kws tshaj lij cov tswv yim tam sim no, peb pom zoo cov ntsiab lus tseem ceeb hauv qab no ntawm cov khoom siv tom qab AKI thiab AKD (Table 1).8 Kev ua raws li tag nrho cov pob khoom lossis cov khoom siv ntawm tus kheej tuaj yeem siv los ua qhov ntsuas tau zoo nyob rau lub sijhawm. Lub raum Function Check, Advocacy, Tshuaj, Siab, Sick Day Protocols care bundle suav nrog kev kuaj lub raum ua haujlwm, suav nrog kev kwv yees GFR thiab qhov ntsuas ntawm tubular thiab glomerular dysfunction (xws li albuminuria, proteinuria). Kev tswj ntshav siab, nrog rau kev tshuaj xyuas cov tshuaj, yog qhov tseem ceeb tshaj plaws, tshwj xeeb tshaj yog hais txog cov khw muag tshuaj thiab tshuaj ntsuab. Kev sib txuas lus nrog lwm tus kws kho mob thiab tus neeg mob yog qhov tseem ceeb, tshwj xeeb tshaj yog nyob rau hauv cov tshuaj uas yuav xav tau kev saib xyuas thaum lub sijhawm muaj mob hnyav (xws li, cov tshuaj tau tso tawm feem ntau los ntawm lub raum thiab cov tshuaj nephrotoxic, raum tso tawm cov tshuaj nephrotoxic [KENDS]). Ua tib zoo saib xyuas KENDS, tshuaj xyuas tshuaj, thiab kev sib haum xeeb yog ib feem tseem ceeb ntawm AKI thiab AKD kev saib xyuas thiab yuav tsum tshwm sim thaum thawj zaug tso tawm thiab tag nrho cov chaw kho mob yav tom ntej.20 Txawm hais tias cov kws kho mob nephrologist yog qhov tsim nyog los ua cov tshuaj tom qab AKI thiab AKD tshuaj xyuas thiab kev sib haum xeeb, qhov no tuaj yeem ua tau los ntawm cov kws muag tshuaj. Ntau yam ntawm cov khoom no tsis yog muab los ntawm ntau qhov kev tshawb fawb, tab sis lawv tag nrho cov hauv paus hauv kev pom zoo saib xyuas rau cov neeg mob nrog AKI.6 Kev ua raws li txoj hauv kev no yuav muaj peev xwm muab cov tswv yim tswj xyuas zoo thiab kev saib xyuas tus qauv. Kev soj ntsuam ntawm kev ua raws li kev ua raws cai thiab cov txiaj ntsig kev kho mob tom ntej yuav ua rau kev txhim kho cov pov thawj muaj zog dua rau kev saib xyuas cov neeg mob no.

Cistanche deserticola prevents kidney disease

Kev txhim kho kev saib xyuas rau cov neeg mob AKD yuav tsum muaj kev hloov pauv los ntawm kev tswj hwm tam sim no raws li Table 1. Tom qab mob raum raug mob thiab mob raum mob raum kev kho mob pob khoom KAMPS Cheebtsam raum Kev Ua Haujlwm Saib Xyuas Lub raum ua haujlwm ntsuas los ntawm cov ntshav creatinine lossis cystatin C; ntsuas los yog kwv yees glomerular filtration rate Proteinuria los yog albuminuria Thaum muaj, xav txog biomarkers, imaging, thiab lwm yam kev ntsuam xyuas raws li qhov ua tau thiab qhia Kev Tawm Tsam Tus Neeg Mob thiab tus neeg saib xyuas kev kawm txog kev mob raum mob thiab mob raum mob Kev sib txuas lus nrog lwm tus kws kho mob (xws li, kws kho mob, kws noj zaub mov, Cov kws saib xyuas neeg mob, kws muag tshuaj, thiab cov neeg ua haujlwm hauv zej zog) Cov tshuaj noj tshuaj kho kom sib haum xeeb, tshuaj xyuas, thiab kev tswj hwm: tshwj xeeb, sib tham txog cov txiaj ntsig ntawm kev pheej hmoo ntawm angiotensin-hloov enzyme inhibitors thiab angiotensin receptor blockers Tshuaj xyuas KENDs thiab tshaj cov tshuaj tiv thaiv kev kub siab kom tus neeg mob nkag siab txog ntshav siab cov hom phiaj thiab cov hom phiaj sib tham. Cov dej num zoo, qhov hnyav zoo tshaj plaws thiab lub luag haujlwm ntawm cov tshuaj diuretics Sick Day raws tu qauv Qhia cov neeg mob txog cov tshuaj uas xav tau kev saib xyuas thaum muaj mob hnyav Xav txog cov txheej txheem txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau tshem tawm cov tshuaj nephrotoxic KD Liu li al.: Zoo thiab Kev Nyab Xeeb rau Mob raum Kab Mob REVIEW raum International Reports ( Xyoo 2020) 5, 1634–1642 1637kev ua ntej thiab kev siv zog. Kev pheej hmoo tsim nyog, kev kho mob raws sij hawm thiab txhim khu kev qha, thiab kev kawm ntawm cov neeg mob, lawv cov neeg zov me nyuam, thiab cov kws kho mob tsis yog nephrologist tuaj yeem yog cov tswv yim los txhim kho kev saib xyuas. Cov txheej txheem kev saib xyuas tom qab AKI thiab AKD pib rau tus neeg mob nyob rau lub sijhawm kuaj mob hauv tsev kho mob AKI, txuas ntxiv hauv zej zog, thiab yuav tsum suav nrog txhua qhov kev nyeem ntawv. Txhua lub sijhawm no yuav tsum muaj kev cuam tshuam tshwj xeeb, nrog cov kws kho mob nephrologists ua tus txheej txheem AKI thiab AKD ntau yam.


Txhawm rau pib, kev saib xyuas yuav tsum tsom mus rau kev hloov pauv ntawm AKI rau CKD, tshwj xeeb tshaj yog hais txog kev pheej hmoo siab rau ESRD tom ntej thiab kab mob plawv. Vim tias tsuas yog qee tus neeg mob uas muaj mob hnyav AKI lossis AKD (piv txwv li, theem 2 lossis 3 AKI) tau txais kev mob siab rau kev soj ntsuam nephrology, qhov tseem ceeb ntawm qhov xav tau kev kho mob rau lub sijhawm ntev nephrology ua ntej nyob rau hauv tus neeg mob yuav tsum tso cai kom tsim nyog. tus neeg mob tom qab. Nyob rau hauv ib tug retrospective propensity score-match cohort txoj kev tshawb no, nephrology kev soj ntsuam tom qab AKI tau txuam nrog qis tag nrho-ua rau tuag piv nrog non-nephrology kev saib xyuas (kev phom sij piv ¼ 0.76, 95 feem pua ​​​​ntawm kev ntseeg siab, {{12 }}.62–{14}}.93). Txawm li cas los xij, qhov txiaj ntsig ntawm qhov txiaj ntsig no yuav tsum tau tshawb xyuas ntxiv, tej zaum dhau los ntawm kev sim tshuaj ntsuam xyuas randomized, txhawm rau txiav txim siab cov txiaj ntsig ntawm kev soj ntsuam hauv cov ntaub ntawv tsis zoo ntawm AKI.14.



Nqe Lus Nug 3: Kev Kho Mob Tom Qab AKI thiab AKD Yuav Tsum Ua Raws Li Cov Ntaub Ntawv Pov Thawj thiab Txhim Kho Nrog Cov Ntaub Ntawv Tshaj Tawm

Kev tiv thaiv Tertiary suav nrog kev tswj hwm tus txheej txheem kab mob tom qab nws tau pom tseeb hauv kev kho mob. Kev raug mob raum mob hnyav ua rau muaj qhov tshwm sim ntawm de novo CKD, 30- hnub nyeem ntawv tom qab tso tawm, kev lim dej mus sij hawm ntev, kev raug mob hauv nruab nrog cev, thiab kev tuag.21–24 Kev tiv thaiv tertiary ntawm AKI yuav tsum tsom rau kev saib xyuas lossis txhim kho kom zoo. ntawm lub neej tom qab AKI kom txo tau cov kev mob mus sij hawm ntev los yog qhov tshwm sim.25 Txawm li cas los xij, nrog rau lwm thaj chaw ntawm kev saib xyuas tom qab AKI thiab AKD, tsis muaj cov pov thawj qib siab uas cov kev npaj saib xyuas tam sim no cuam tshuam rau cov txiaj ntsig no.

Tus nqi ntawm kev kuaj mob raum cuam tshuam tom qab tso tawm hauv tsev kho mob tsawg. Hauv Tebchaws Meskas hauv 2013, kev soj ntsuam creatinine ntsuas tom qab ib ntus ntawm AKI tshwm sim hauv 6 lub hlis hauv tsuas yog 54 feem pua ​​​​ntawm cov neeg mob uas tseem muaj sia nyob.26 Cov ntaub ntawv no tseem ceeb dua thaum ib tus xav tias tom qab AKI lossis AKD, ntau tus neeg mob tsawg dua muaj qhov ntau. proteinuria, parathyroid hormone, hemoglobin, thiab phosphorus ntsuas. Txawm hais tias tsis yog txhua tus neeg mob AKI thiab AKD yuav xav tau txhua qhov kev ntsuas no, cov ntaub ntawv rov qab qhia tau tias qee tus neeg mob tsim nyog tau txais tus qauv nephrology ua raws.27

Ntau tus kws tshawb fawb AKI tau tawm tswv yim tias lub sijhawm hloov pauv ntawm AKI thiab CKD yuav yog lub sijhawm los cuam tshuam. Txawm li cas los xij, tam sim no, tsis muaj pov thawj kev cuam tshuam ua rau lub hom phiaj tiv thaiv lub cev mus ntev hauv cov neeg mob AKD. Cov qauv tsiaj tshiab thiab txwv cov ntaub ntawv rov qab rau tib neeg tau qhia tias muaj kev cuam tshuam nrog kev txhim kho ntshav siab, kev zam ntawm nephrotoxins, thiab pib ntawm renin-angiotensin-aldosterone system (RAAS) blockade agents28,29 lossis mineralocorticoid receptor antagonists30 tuaj yeem tiv thaiv kev mob raum thiab nws cov teeb meem. Txawm li cas los xij, hauv tib neeg, tom qab ib ntus ntawm AKI, kev tswj hwm ntawm RAAS cov neeg ua haujlwm tuaj yeem ua rau muaj kev pheej hmoo siab rau hyperkalemia nrog rau kev xav tau rau kev mus pw hauv tsev kho mob nephrology.29

Hauv kev tshawb nrhiav rov qab los ntawm Asmeskas cov neeg laus, cov neeg mob tom qab AKI tau nce 22 feem pua ​​​​ntawm qhov kev pheej hmoo ntawm kev mob ntshav siab.31 Txawm li cas los xij, RAAS cov neeg ua haujlwm cuam tshuam nrog kev ua haujlwm AKI, tshwj xeeb tshaj yog nyob rau hauv kev teeb tsa mob hypovolemia.6,32,33 Tom qab. ib qho kev mus pw hauv tsev kho mob, cov neeg mob muaj kev pheej hmoo rau kev txiav tshuaj tsis tu ncua, thiab cov neeg mob ntshav siab feem ntau raug txiav tawm thaum tus neeg mob nyob hauv qhov chaw ntawm hypotension lossis hloov mus rau chav kho mob hnyav. Yog li ntawd, kev kho tshuaj kho mob yog qhov tseem ceeb ntawm kev saib xyuas tom qab AKI thiab AKD. Cov kev tsis sib xws yuav tsum raug suav nrog tom qab tso tawm hauv tsev kho mob kom ntseeg tau tias lawv tau ua raws li cov hom phiaj tau pom zoo los ntawm kev kub siab, ntshav qab zib, lipid, thiab CKD cov lus qhia.34


Los ntawm kev tshawb fawb pej xeem raws li kev tshawb fawb, kev siv statin cuam tshuam nrog txo kev pheej hmoo rau 1- xyoo thiab kev tuag hauv tsev kho mob hauv cov neeg mob ntshav qab zib uas xav tau AKI (AKI-D) 35 thiab nrog kev txo qis hauv cov neeg mob ntshav qab zib. CKD.36 Cov ntaub ntawv los ntawm kev rov qab los ua pov thawj pom tias hauv cov neeg mob ntshav qab zib uas muaj keeb kwm ntawm AKI-D, dipeptidyl peptidase 4 inhibitors siv yog cuam tshuam nrog kev txo qis rau ESRD thiab kev tuag.37 Thaum kawg, qhov chaw kho mob tsis tau txais cov tshuaj uas tau raug cuam tshuam tshwj xeeb. thiab cuam tshuam nrog kev pheej hmoo siab rau AKI (piv txwv li, proton-pump inhibitors lossis nonsteroidal anti inflammatory tshuaj) yuav tsum raug zam.38 Txawm hais tias muaj cov ntaub ntawv me me los qhia rau cov lus pom zoo no, kev kho tshuaj kho, kev zam ntawm cov nephrotoxins, thiab kev noj tshuaj kom zoo zoo li. Cov kauj ruam tsim nyog los txhim kho cov txiaj ntsig hauv cov neeg mob tom qab ib ntus ntawm AKI lossis AKD.

Table 2. Acute kidney injury requiring dialysis and acute kidney disease requiring dialysis kidney health care bundle

Nqe Lus 4: Qhov Ntsuas Zoo rau AKI-D thiab Postdischarge AKD-D yuav tsum zoo ib yam li qhov ntsuas tau zoo thaum mus pw hauv tsev kho mob thiab txawv ntawm ESRD Kev Ntsuas. Tsis tas li ntawd, yuav tsum muaj cov kev qhia tshwj xeeb zoo rau qhov chaw kho mob sab nraud (xws li kev ua raws li kev ntsuas qhov hnyav, kev nkag mus, kev qhia, kev tshem tawm, hypotension, cov tshuaj kho mob tuaj yeem txiav txim siab)

Hauv qhov sib piv rau ESRD cov pej xeem, tam sim no tsis muaj qhov ntsuas tau zoo rau kev saib xyuas AKI-D.39 Ib qho kev txwv tseem ceeb yog qhov tsis muaj qhov loj, qhov kev cia siab, kev sim tshuaj ntsuam xyuas los txhawb cov kev ntsuas tshwj xeeb.40 Kev ntsuas kab mob raum kawg. tej zaum yuav tsis tsim nyog rau cov neeg AKI, vim tias cov neeg mob AKI yuav muaj kev pheej hmoo ntau dua rau cov teeb meem thiab tseem muaj lub hom phiaj ntawm lub raum ua haujlwm rov qab. Kev txiav txim siab txog yam uas kwv yees thiab txhawb nqa lub raum rov qab tom qab AKI-D tuaj yeem pab txhim kho kev saib xyuas zoo. Kev tsim ntxov ntxov ntawm cov neeg mob AKI-D raws li ESRD tuaj yeem ua rau lub sijhawm ploj mus los txhawb lub raum rov zoo.41


Raws li cov neeg mob AKI-D hloov pauv los ntawm lub sijhawm mob hnyav mus rau qhov chaw kho mob sab nraud, nws yog ib qho tseem ceeb rau lawv kom raug lees paub tias yog cov neeg muaj kev xav tau tshwj xeeb. Qhov no pib nrog kev tsim nyog tso tawm rau pab neeg mob sab nraud thiab suav nrog kev qhia cov kws kho mob thiab cov neeg mob lawv tus kheej. Raws li cov ntaub ntawv rov qab los thiab cov kws tshaj lij kev xav, peb tsis ntev los no tau hais txog cov ntsiab lus tseem ceeb (Kev Ntsuas Qhov Ntsuas, Kev Nkag Mus, Kev Qhia, Kev Ncua, Hypotension, thiab Cov Tshuaj Kho Mob) (Table 2) rau kev saib xyuas zoo AKI-D hauv qhov chaw kho mob sab nraud. .8


Kev ntsuas qhov hnyav

In contrast to the paradigm of dry weight challenges for ESRD patients, AKI-D patients may require a mild permissive hypervolemia approach that emphasizes avoiding intradialytic hypotension (IDH). The dangers of IDH and high ultrafiltration rates (>13 ml/kg/h) hauv cov neeg mob ESRD tau piav qhia tau zoo.42 Hauv AKI-D, IDH tuaj yeem ua rau lub raum mob ischemic hnyav dua thiab txo qhov kev pheej hmoo rov qab los.43 Ob txoj kev tshawb fawb rov qab tau pom tias cov nqi ultrafiltration ntau dua thiab nquag IDH yog. cuam ​​tshuam nrog qhov qis dua ntawm kev rov qab los ntawm cov neeg mob sab nraud nrog AKI D.43,44 Yam tsawg kawg nkaus, cov neeg mob AKI-D yuav tsum muaj kev soj ntsuam tsis tu ncua (txhua lub limtiam) ntawm lub hom phiaj qhov hnyav thiab cov hom phiaj tshem tawm cov kua dej. Hauv cov neeg mob uas tsis yog mob anuric, diuretics yuav pab tau kom txo qis qhov hnyav ntawm interdialytic nce thiab txo qis ultrafiltration rates.45 Lub luag haujlwm ntawm kev ntsuas tshwj xeeb los tiv thaiv IDH, xws li kev lim dej txias lossis sodium modeling, tsis tau raug soj ntsuam hauv AKI qhov chaw.


Nkag mus

Yuav luag txhua tus neeg mob AKI-D yuav muaj lub hauv paus venous catheter ua thawj nkag. Tsis tas li ntawd, qhov kev tso tawm ntawm cov hlab ntsha yuav tsum tau ncua (tsim nyog) thaum saib xyuas lub raum kev ua haujlwm rov qab.46 Cov neeg mob no thiab lawv tsev neeg yuav muaj kev pheej hmoo loj rau kev kis kab mob, thiab lawv yuav tsum tau txais kev kho mob hauv nruab nrab venous catheter thiab kev kawm ua ntej tawm hauv tsev kho mob, uas. yuav tsum txuas ntxiv ua tus neeg mob sab nraud. Txawm hais tias muaj cov ntaub ntawv txwv tsis pub muaj txog cov teeb meem hauv nruab nrab ntawm cov hlab ntsha hauv cov neeg uas muaj AKI-D, ntau tuaj yeem kawm tau los ntawm kev tshawb nrhiav hauv lwm cov neeg uas muaj lub hauv siab venous catheters.47,48 Cov neeg mob uas muaj AKI-D yuav tsum tau txais kev cob qhia txog kev khaws cov leeg. Kev xa tawm ntawm cov kev kawm no yog ib qho piv txwv zoo ntawm kev ntsuas tseem ceeb thiab yooj yim rau kev noj qab haus huv thiab cov chaw lim ntshav kom taug qab.


Kev qhia

Los ntawm kev txhais, AKI-D yog qhov muaj peev xwm thim rov qab, thiab cov kev tshawb fawb qhia tias nce mus txog 40 feem pua ​​​​ntawm cov neeg mob AKI-D uas tau tso tawm ntawm kev lim ntshav tuaj yeem rov qab mus rau kev lim ntshav.44,49,50 Cov neeg mob thiab lawv cov neeg saib xyuas yuav tsum tau kawm. los saib xyuas lub raum ua haujlwm rov qab. Ntau tus neeg mob AKI-D yuav tsis tau txais txiaj ntsig ntawm kev saib xyuas nephrology ua ntej muaj mob hnyav, yog li kev kawm dav dav txog kev noj qab haus huv ntawm lub raum yuav tsum suav nrog thaum tsim nyog.14,46 Hauv qhov chaw lim ntshav, cov neeg mob AKI-D yuav tsum qhia kom meej meej cais. los ntawm cov neeg mob ESRD. Cov neeg mob uas tau lim ntshav-yuav tsum tau AKI yuav tsum tau txais lub rooj sib tham txog kev saib xyuas tsis tu ncua (zoo ib yam li cov txheej txheem ESRD) uas qhia txog tus kheej txoj kev kho mob thiab kev cia siab ntawm tus kheej rau lub raum rov qab.

Table 3. Potential quality score card to track follow-up care of patients with AKI/AKD

Clearance

Peb ntseeg hais tias cov chaw kho mob rau cov neeg mob AKI-D yuav tsum muaj cov txheej txheem tsim nyog kom tso cai rau kev kuaj ntshav thiab zis ntau zaus, soj ntsuam rau lub raum rov zoo.46 Qhov no tuaj yeem ua tiav los ntawm kev ua haujlwm ntawm ntshav (xws li trending predialysis SCr) thiab cov zis sij hawm. kev sau, thiab yuav tsum tau ua raws li tsawg kawg ib lub lim tiam thaum lub sij hawm hloov mus rau tus neeg mob sab nraud.51

Dialysis clearance kuj yuav tsum tau ntsuas thiab siv los qhia ntawv. Cov ntaub ntawv pov thawj los ntawm qhov loj-scale, randomized tswj acute tubular necrosis sim qhia tau hais tias rau cov neeg mob AKI-D, xa Kt / tv urea ntawm 1.2 thrice ib lub lim tiam tuaj yeem suav tias yog qhov txaus dialytic clearance.52 Txawm li cas los xij, cov neeg mob AKI-D yuav muaj ntau dua. Cov kev xav tau ntawm tus kheej, xws li catabolism ntau dua yuav tsum tau lim ntshav ntau ntxiv rau kev tswj cov tsos mob ntawm uremia. Hloov pauv, cov neeg mob uas pib rov qab ua haujlwm rau lub raum tuaj yeem ua rau lub ntsej muag lim ntshav kom tsawg dua 3 lub lis piam.


Hypotension

Intradialytic hypotension yog txuam nrog cov txiaj ntsig tsis zoo thiab tuaj yeem txo qis qhov tshwm sim ntawm lub raum kev ua haujlwm rov qab rau cov neeg mob AKI-D.43,44 Hais txog qhov tseem ceeb ntawm kev txwv qhov hnyav ntawm interdialytic yog qhov tseem ceeb, ib yam li kev ceev faj kho cov tshuaj tiv thaiv.


Tshuaj

Ib yam li kev hloov pauv hauv cov chaw kho mob, kev txav mus rau cov neeg mob sab nraud kev tswj hwm AKI-D yuav tsum tau nrog kev tshuaj xyuas thiab rov kho cov tshuaj.53,54 Cov txheej txheem tshuaj xyuas thiab kev sib haum xeeb yuav tsum tau rov ua dua, tshwj xeeb tshaj yog thaum lub raum kev ua haujlwm pib rov zoo, rau xyuas kom muaj kev noj tshuaj kom txaus thiab tsim nyog.20 Cov neeg mob yuav tsum tau kawm txog qhov muaj feem cuam tshuam ntawm lub raum tsis ua haujlwm thiab kev lim ntshav ntawm cov tshuaj tshem tawm, tab sis lawv kuj yuav tsum tau qhia tias thaum lub raum ua haujlwm pib rov zoo, cov tshuaj tshem tawm yuav raug txhim kho thiab kev siv tshuaj yuav tsum tau ua. yuav tsum tau nce los yog txawm txiav. Kev tshuaj xyuas tshwj xeeb ntawm cov tshuaj nephrotoxic thiab KENDS kuj yuav tsum tau ua.20


Ntxiv nrog rau cov kev ntsuas muaj peev xwm no uas tsom mus rau cov txheej txheem ntawm kev saib xyuas, qhov zoo tshaj plaws, cov txiaj ntsig ntsuas xws li cov nqi nkag hauv tsev kho mob thiab kev lim ntshav kev ywj pheej rov qab yuav tsum tau saib xyuas. Txawm li cas los xij, tam sim no tsis muaj cov qauv ntsuas, thiab cov nqi no yuav txawv raws li tus neeg mob tus yam ntxwv. Muab qhov tsis txaus ntawm cov ntaub ntawv hauv cheeb tsam no, kev saib xyuas cov nqi no tuaj yeem pab txheeb xyuas cov xwm txheej thiab muaj peev xwm txhim kho kom zoo.

Cistanche cures kidney disease, click here to learn more

Cistanche kho mob raum, nyem qhov no kom paub ntau ntxiv

Cov lus xaus

Kev ntsuas kev ua tau zoo yog xav tau rau kev tswj hwm cov neeg mob AKI thiab AKD tom qab qhov ntsuas ntsuas hauv tsev kho mob kom ua qauv saib xyuas thiab txhim kho cov txiaj ntsig ntawm tus neeg mob. Tsawg tus neeg mob tau txais kev soj ntsuam kuaj mob raum ua haujlwm lossis kev saib xyuas tom qab AKI thiab AKD. Table 3 muab daim ntawv qhab nia zoo tshaj plaws rau kev saib xyuas kev noj qab haus huv kom pib saib xyuas thiab txhim kho AKI thiab AKD kev saib xyuas. Txawm hais tias qhov cuab yeej no tsis tau raug lees paub, nws yog raws li cov ntaub ntawv luam tawm tsawg thiab cov kws tshaj lij kev xav. Nws khaws cov lej tseem ceeb uas lub tuam txhab yuav tsum tau taug qab hauv lub sijhawm luv thiab ntev los saib xyuas cov neeg mob AKI thiab AKD. Ib yam li ntawd, Daim Ntawv Ntxiv Ntxiv A thiab Daim Duab Ntxiv S1 muab qhov kev txhim kho zoo tshaj plaws uas cuam tshuam txog kev saib xyuas cov neeg mob AKI thiab AKD.

Nyob rau yav tom ntej, cov txiaj ntsig xws li 30- hnub nyeem ntawv tus nqi, tus nqi kis kab mob hauv lub catheter, thiab kev tuag luv luv thiab ntev tom qab ib ntu ntawm AKI lossis AKD tej zaum yuav yog cov kev ntsuas zoo uas yuav raug tshaj tawm. Txog tam sim no, cov tsev kho mob yuav tsum paub txog tus naj npawb ntawm cov neeg mob uas tau lees paub tom qab-AKI lossis AKD kev saib xyuas nrog rau kev taug qab cov neeg uas mus txuas ntxiv kom tau txais qee yam kev soj ntsuam. Kev saib xyuas kev mob siab rau qhov no tuaj yeem muab los ntawm cov kws kho mob nephrology lossis cov kws kho mob uas tsis yog nephrology thiab qhov no yuav yog ib qho tseem ceeb rau kev taug qab. Kev txhim kho kev ua haujlwm thiab kev tshawb fawb yav tom ntej tuaj yeem tsom mus rau qhov zoo tshaj plaws kev tswj cov tswv yim thiab kev soj ntsuam kev ua tau zoo ntawm KAMPS thiab Kev Ntsuas Kev Ntsuas, Kev Nkag Mus, Kev Qhia, Clearance, Hypotension, thiab Cov Tshuaj Kho Mob thiab cov peev txheej txhim kho thiab siv tau ntawm cov pob khoom tshiab.

1Division of Nephrology, Departments of Medicine and Anesthesia, University of California, San Francisco, California, USA; 2Division of Critical Care Medicine, Departments of Medicine and Anesthesia, University of California, SanFrancisco, Cali-fornia, USA;3Department of Clinical and Experimental Medicine, Kws Qhia Ntawv ntawm Kev Noj Qab Haus Huv thiab Kev Kho Mob Sciences, University of Surrey, Royal Surrey County Tsev Kho Mob NHS Foundation Trust, Guildford, Surrey, UK;4Division of Nephrology, Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA;5Division of Nephrology, Department of Internal Medicine, National Taiwan University Tsev Kho Mob, Taipei, Taiwan;6Center for Critical Care Nephrology, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA;7Division of Nephrology, Department of Medicine, University of California, San Diego Medical Center, San Diego, San Diego, California, USA;8Department of Medicine (DIMED), University of Padova, Padova, Ltalis;9Department of Nephrology, Dialysis thiab Transplantation, thiab International Renal Research Institute, San Bortolo Tsev Kho Mob, Vicenza, Ltalis;10Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA;11Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA;12Division of Nephrology, University of Virginia Health System, Charlottesville, Virginia, USA;13Kws qhia ntawv kho mob, Otto-von-Guericke University Magdeburg thiab Diaverum MVZ, Potsdam, Lub teb chaws Yelemees; thiab14Section of Nephrology, Department of Medicine, University of Chicago, Chicago, Illinois, Tebchaws USA


Qhia tawm

JLK yog tus kws pab tswv yim rau Astute Medical, Sphingotec, thiab Baxter thiab tau txais kev tshawb fawb los ntawm NxStage, Astute Medical, thiab Satellite Health Care. KDL yog tus kws pab tswv yim rau Direct, Quark, thiab Portero; yog nyob rau pawg thawj coj saib xyuas rau AstraZeneca; yog tus hais lus rau Baxter, thiab yog tus tswv ntawm Amgen. LGF tau txais kev txhawb nqa kev tshawb fawb los ntawm Baxter, La Jolla Pharmaceuticals, thiab Ortho-Clinical-Diagnostics thiab tau txais kev qhuas los ntawm Baxter, La Jolla Pharmaceuticals, Ortho-Clinical Diagnostics, MediBeacon, thiab Fresenius. JAK yog tus kws pab tswv yim rau Adrenomed, Astute Medical, Baxter, bio Mérieux, Bioporto, Davita, Fresenius, Mallinckrodt, Novartis, NxStage, Potrero, RenalSense, thiab Sphingotech thiab tau txais kev txhawb nqa los ntawm Astute Medical, Baxter, bioMérieux, thiab RenalSense. MH yog tus kws tshaj lij thiab kws tshaj lij rau Abbott, Alere, Baxter, Novartis, Siemens, Roche, thiab FastBiomedical thiab tau txais kev txhawb nqa los ntawm Abbott Diagnostics. RLM yog nyob rau hauv pawg thawj coj saib xyuas rau Astute Medical, Baxter, Mallinckrodt, thiab Indalo Therapeutics thiab tau txais nyiaj tshawb fawb los ntawm Fresenius, Fresenius-Kabi, Grifols, thiab Relypsa. MHR tshaj tawm txog kev qhuas los ntawm American Society of Nephrology thiab Baxter thiab ua haujlwm ntawm cov ntaub ntawv saib xyuas kev nyab xeeb rau Retrophin thiab Reata Pharmaceuticals. Tag nrho lwm tus kws sau ntawv tshaj tawm tsis muaj kev sib tw nyiam.



REFERENCES

1. Chertow GM, Burdick E, Honour M, et al. Mob raum raug mob, kev tuag, kev nyob ntev, thiab cov nqi hauv tsev kho mob cov neeg mob. J Am Soc Nephrol. 2005; 16:3365–3370.

2. Hobson C, Ozrazgat-Baslanti T, Kuxhausen A, et al. Tus nqi thiab kev tuag cuam tshuam nrog kev raug mob raum tom qab mob. Ann Surg. 2015; 261:1207–1214.

3. Meersch M, Schmidt C, Hoffmeier A, et al. Kev tiv thaiv kev phais plawv-koom nrog AKI los ntawm kev siv KDIGO cov lus qhia hauv cov neeg mob uas muaj kev pheej hmoo siab pom los ntawm biomarkers: PrevAKI randomized tswj kev sim. Intensive Care Med. 2017; 43: 1551–1561.

4. Gocze I, Jauch D, Gotz M, et al. Biomarker-coj kev cuam tshuam los tiv thaiv mob raum raug mob tom qab kev phais loj: txoj kev tshawb fawb randomized BigpAK. Ann Surg. 2018; 267: 1013–1020.

5. Selby NM, Casula A, Lamming L, et al. Ib lub koom haum-theem kev pab cuam ntawm kev cuam tshuam rau AKI: lub pragmatic stepped wedge pawg randomized sim. J Am Soc Nephrol. 2019; 30:505–515.

6. Kab mob raum: Txhim kho Ntiaj Teb Cov Kev Ua Haujlwm (KDIGO) Pab Pawg Ua Haujlwm Mob Raum Mob. KDIGO Clinical Practice Guideline for Acute raum Injury. Raum Int. 2012; (suppl): 1–138.

7. Chawla LS, Bellomo R, Bihorac A, et al. Mob raum mob thiab lub raum rov qab: daim ntawv tshaj tawm pom zoo ntawm Cov Kab Mob Zoo Tshaj Plaws (ADQI) 16 Workgroup. Nat Rev Nephrol. 2017; 13:241–257.

8. Kashani K, Rosner MH, Haase M, et al. Lub hom phiaj txhim kho kom zoo rau mob raum raug mob. Clin J Am Soc Nephrol. Xyoo 2019; 14: 941–953.

9. Sawhney S, Marks A, Fluck N, et al. Tom qab tso lub raum ua haujlwm yog cuam tshuam nrog kev pheej hmoo ntawm lub raum mus rau kaum xyoo tom qab ntawm cov neeg muaj sia nyob ntawm lub raum raug mob. Raum Int. 2017; 92:440–452.

10. Siew ED, Peterson JF, Eden SK, et al. Tus neeg mob nephrology xa mus rau tus nqi tom qab mob raum raug mob. J Am Soc Nephrol. 2012; 23:305–312.

11. Karsanji DJ, Pannu N, Manns BJ, et al. Kev tsis sib haum xeeb ntawm cov kws kho mob nephrologists cov kev xav thiab cov kev coj ua niaj hnub rau hauv zej zog kev soj ntsuam tom qab AKI mus pw hauv tsev kho mob. Clin J Am Soc Nephrol. 2017; 12:1753–1761.

12. Mishra PK, Luckraz H, Nandi J, et al. Lub neej ntev ntev tom qab mob raum raug mob hauv cov neeg mob plawv. Ann Card Anaesth. 2018; 21:41–45.

13. James MT, Pannu N, Hemmelgarn BR, et al. Derivation thiab sab nraud validation ntawm kev twv ua qauv rau cov mob raum mob siab tom qab mob raum raug mob. JAMA. 2017; 318: 1787–1797.

14. Harel Z, Wald R, Bargman JM, et al. Kev soj ntsuam nephrologist txhim kho txhua qhov ua rau tuag ntawm cov neeg mob lub raum raug mob hnyav. Raum Int. 2013; 83:901–908.

15. Sawhney S, Marks A, Fluck N, et al. Mob raum raug mob raws li ib qho kev pheej hmoo ntawm kev ywj pheej rau kev npaj tsis tau npaj rau 90-hnub tsev kho mob nyeem ntawv. BMC NPE. Xyoo 2017; 18: 9.

16. Silver SA, Harel Z, McArthur E, et al. 30- hnub nyeem ntawv tom qab mob raum raug mob hauv tsev kho mob. Mas J Med. 2017; 130, 163.e164–172.e164.

17. Lee BJ, Hsu CY, Parikh RV, et al. Tsis rov qab los ntawm kev lim ntshav- yuav tsum tau mob raum raug mob thiab kev tuag luv luv thiab kev pheej hmoo mob plawv: kev tshawb fawb sib koom ua ke. BMC NPE. Xyoo 2018; 19:134.

18. Bansal N, Matheny ME, Greevy RA Jr, et al. Mob raum raug mob thiab muaj feem yuav tshwm sim plawv tsis ua hauj lwm ntawm US qub tub rog. Am J Raum Dis. 2018; 71:236–245.

19. Hsu CY, Chinchilli VM, Coca S, et al. Tom qab mob raum raug mob proteinuria thiab kab mob raum tom ntej: Kev Ntsuam Xyuas, Kev Ntsuam Xyuas Serial, thiab Tom Qab Sequelae hauv Acute Raum Injury (ASSESS-AKI). JAMA Intern Med. 2020; 180:402–410. Ostermann M, Chawla LS, Forni LG, et al. Kev tswj cov tshuaj nyob rau hauv mob raum kab mob - daim ntawv qhia txog tus kab mob mob


Koj Tseem Yuav Zoo Li