终末期肝病中的急性肾损伤与肝肾综合征

陈文激; 梁威; 周永健

doi:10.3969/j.issn.1001-5256.2020.11.006

终末期肝病中的急性肾损伤与肝肾综合征

DOI: 10.3969/j.issn.1001-5256.2020.11.006

广州市第一人民医院华南理工大学附属第二医院消化内科

基金项目:

国家自然科学基金全面上项目（81970507）；广东省自然科学基金面上项目（2020A1515010100）；广州市科技项目（201904010132）；广州市卫健委高科技术项目（2019GX004）；

详细信息

中图分类号: R692;R575
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出版历程
- 收稿日期: 2020-07-29
- 出版日期: 2020-11-20

Acute kidney injury and hepatorenal syndrome in end-stage liver disease

Department of Gastroenterology,Guangzhou First People's Hospital & The Second Affiliated Hospital of South China University of Technology

Research funding:

摘要

摘要:
急性肾损伤、肝肾综合征是终末期肝病患者出现的,以肾损伤为主要表现的严重并发症,两者相互联系,又有所区别。急性肾损伤分为肾前性、肾性、肾后性,1型肝肾综合征被视为特殊的急性肾损伤,不同类型的急性肾损伤其治疗方法不同。近年随着急性肾损伤、慢性肾脏病等诊断标准的不断完善,肝肾综合征的诊断标准、分型亦被更新;在发病机制上,由肠菌移位引起的系统性炎症日益受到重视;既往认为肝肾综合征是功能性肾损伤,但近期有证据提示肾结构性损伤的存在;血管收缩剂联合白蛋白是目前肝肾综合征主要的药物治疗。围绕终末期肝病中急性肾损伤的诊治,以及肝肾综合征近年在诊断标准、分型、病理、发病机制、治疗方面的进展作一综述。
- 终末期肝病 /
- 急性肾损伤 /
- 肝肾综合征
Abstract:
Acute kidney injury( AKI) and hepatorenal syndrome( HRS) are serious complications in patients with end-stage liver disease,with renal injury as the main manifestation. They are interrelated,but also different from each other. There are several types of AKI,i. e.,prerenal AKI,intrarenal or intrinsic AKI,and post-renal AKI,and type 1 HRS is considered a special type of AKI. There are different therapies for different types of AKI. With the improvement in the diagnostic criteria for AKI and chronic kidney disease in recent years,the diagnostic criteria and classification of HRS have also been updated. As for pathogenesis,systemic inflammation caused by intestinal bacterial translocation is attracting more and more attention. HRS was considered functional renal injury in the past,but recent evidence suggests the existence of structural injury. Vasoconstrictor combined with albumin is the main therapeutic drug for HRS. This article reviews the diagnosis and treatment of AKI in end-stage liver disease and the recent advances in the diagnostic criteria,classification,pathology,pathogenesis,and treatment of HRS.
- end-stage liver disease /
- acute kidney injury /
- hepatorenal syndrome

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参考文献(37)

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