文档介绍：KDIGO急性肾损伤指南解读
KDIGO Clinical Practice Guideline for Acute Kidney Injury
Kidney inter. Suppl. 2012; 2: 1–138
GRADE 系统
总推荐条目87条
%
%
%
1A:9 %
1B:10 %
1C:3 %
2A:2 %
2B:10 %
2C:20 %
2D:7 %
内容
Introduction and Methodology
AKI Definition
Prevention and Treatment of AKI
Contrast-induced AKI
Dialysis Interventions for Treatment of AKI
符合下列任何一条即可诊断
1. Increase in SCr by ≥ mg/dl (≥ lmol/l) within 48 hours
2. Increase in SCr to ≥ times baseline, which is known or presumed to have occurred within the prior 7 days
3. Urine volume < ml/kg/h for 6 hours.
AKI 诊断(Not Graded)
The cause of AKI should be determined whenever
possible. (Not Graded)
Selected causes of AKI requiring
immediate diagnosis and specific
therapies mended diagnostic tests
Decreased kidney perfusion Volume status and urinary
diagnostic indices
Acute glomerulonephritis, vasculitis, Urine sediment examination,
interstitial nephritis, thrombotic serologic testing and
Microangiopathy hematologic testing
Urinary tract obstruction Kidney ultrasound
We mend that patients be stratified for risk of AKI according to their susceptibilities and exposures. (1B)
Manage patients according to their susceptibilities and exposures to reduce the risk of AKI . (Not Graded)
Test patients at increased risk for AKI with measurements of SCr and urine output to detect AKI. (Not Graded) Individualize frequency and duration of monitoring based on patient risk and clinical course. (Not Graded)
Exposures Susceptibilities
Sepsis Dehydration or volume depletion
Critical illness Advanced age
Circulatory shock Female gender
Burns Black race
Trauma CKD
Cardiac surgery (especially Chronic diseases (heart, lung, liver)
with CPB)
Major noncardiac surgery Diabetes mellitus
Nephrotoxic drugs Cancer
Radiocontrast agents Anemia
Poisonous plants and animals
Causes of AKI: exposures and susceptibilities for non-specific AKI