Advances in research hotspots in liver failure complicated by acute kidney injury
-
摘要: 急性肾损伤(AKI)定义为肾小球滤过率急剧下降和血清肌酐的急骤升高,是肝衰竭患者的严重并发症之一。早期诊断及处理对降低病死率、改善肝衰竭预后极为重要。对肝衰竭患者AKI的诊断标准、发病机制、生物标志物、临床特点及治疗的研究进展进行阐述。指出对AKI的定义、分期不断修正,研发高效的肾损伤生物标记物,是未来研究的方向。Abstract: Acute kidney injury (AKI) is defined as a sharp drop in glomerular filtration rate (GFR) and a rapid increase in serum creatinine and is one of the most serious complications of liver failure. Early diagnosis and treatment play a vital role in reducing the mortality and improving the prognosis of liver failure. This article elaborates on the research advances in the diagnostic criteria, pathogenesis, biomarkers, clinical features, and treatment of AKI and points out that constant modification of the definition and staging of AKI and research and development of efficient biomarkers for AKI are future research directions.
-
Key words:
- liver failure /
- renal insufficiency, acute /
- diagnosis /
- therapeutics /
- biological markers
-
[1]NADIM MK, DURAND F, KELLUM JA, et al.Management of the critically ill patient with cirrhosis:A multidisciplinary perspective[J].J Hepatol, 2016, 64 (3) :717-735. [2]ROSI S, PIANO S, FRIGO AC, et al.New ICA criteria for the diagnosis of acute kidney injury in cirrhotic patients:Can we use an imputed value of serum creatinine?[J].Liver Int, 2015, 35 (9) :2108-2114. [3]ANGELI P, GINS P, WONG F, et al.Diagnosis and management of acute kidney injury in patients with cirrhosis:revised consensus recommendations of the International Club of Ascites[J].J Hepatol, 2015, 62 (4) :968-974. [4]HUELIN P, PIANO S, SOLE, et al.Validation of a staging system for acute kidney injury in patients with cirrhosis and association with acuteon-chronic liver failure[J].Clin Gastroenterol Hepatol, 2017, 15 (3) :438-445.e5. [5]AMATHIEU R, AL-KHAFAJI A, SILEANU FE, et al.Significance of oliguria in critically ill patients with chronic liver disease[J].Hepatology, 2017, 66 (5) :1592-1600. [6]de SEIGNEUX S, MARTIN PY.Preventing the progression of AKIto CKD:The role of mitochondria[J].J Am Soc Nephrol, 2017, 28 (5) :1327-1329. [7]TANDON P, JAMES MT, ABRALDES JG, et al.Relevance of new definitions to incidence and prognosis of acute kidney injury in hospitalized patients with cirrhosis:A retrospective population-based cohort study[J].PLo S One, 2016, 11 (8) :e0160394. [8]SONG TX, QI XS, GAO F, et al.Advances in diagnosis and treatment of hepatorenal syndrome type of acute kidney injury in patients with liver cirrhosis[J].J Clin Hepatol, 2017, 33 (3) :572-576. (in Chinese) 宋廷雪, 祁兴顺, 高帆, 等.肝硬化肝肾综合征型急性肾损伤的诊治进展[J].临床肝胆病杂志, 2017, 33 (3) :572-576. [9]TREEPRASERTSUK S, WONGKARNJANA A, JARUVONGVANICHV, et al.Urine neutrophil gelatinase-associated lipocalin:A diagnostic and prognostic marker for acute kidney injury (AKI) in hospitalized cirrhotic patients with AKI-prone conditions[J].BMC Gastroenterol, 2015, 15:140. [10]PUTHUMANA J, ARIZA X, BELCHER JM, et al.Urine interleukin 18 and lipocalin 2 are biomarkers of acute tubular necrosis in patients with cirrhosis:A systematic review and meta-analysis[J].Clin Gastroenterol Hepatol, 2017, 15 (7) :1003-1013.e3. [11]FRANCOZ C, NADIM MK, DURAND F.Kidney biomarkers in cirrhosis[J].J Hepatol, 2016, 65 (4) :809-824. [12]ARIZA X, SOLE, ELIA C, et al.Analysis of a urinary biomarker panel for clinical outcomes assessment in cirrhosis[J].PLo SOne, 2015, 10 (6) :e0128145. [13]ARIZA X, GRAUPERA I, COLL M, et al.Neutrophil gelatinaseassociated lipocalin is a biomarker of acute-on-chronic liver failure and prognosis in cirrhosis[J].J Hepatol, 2016, 65 (1) :57-65. [14]JIANG QQ, HAN MF, MA K, et al.Acute kidney injury in acute-on-chronic liver failure is different from in decompensated cirrhosis[J].World J Gastroenterol, 2018, 24 (21) :2300-2310. [15]DONG T, ARONSOHN A, GAUTHAM REDDY K, et al.Rifaximin decreases the incidence and severity of acute kidney injury and hepatorenal syndrome in cirrhosis[J].Dig Dis Sci, 2016, 61 (12) :3621-3626. [16]European Association for the Study of the Liver.EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis[J].J Hepatol, 2018, 69 (2) :406-460. [17]DURAND F, GRAUPERA I, GINS P, et al.Pathogenesis of hepatorenal syndrome:implications for therapy[J].Am J Kidney Dis, 2016, 67 (2) :318-328. [18]BOYER TD, SANYAL AJ, WONG F, et al.Terlipressin plus albumin is more effective than albumin alone in improving renal function in patients with cirrhosis and hepatorenal syndrome type 1[J].Gastroenterology, 2016, 150 (7) :1579-1589.e2. [19]CAVALLIN M, KAMATH PS, MERLI M, et al.Terlipressin plus albumin versus midodrine and octreotide plus albumin in the treatment of hepatorenal syndrome:A randomized trial[J].Hepatology, 2015, 62 (2) :567-574. [20]CAVALLIN M, PIANO S, ROMANO A, et al.Terlipressin given by continuous intravenous infusion versus intravenous boluses in the treatment of hepatorenal syndrome:A randomized controlled study[J].Hepatology, 2016, 63 (3) :983-992. [21]FACCIORUSSO A, CHANDAR AK, MURAD MH, et al.Comparative efficacy of pharmacological strategies for management of type 1hepatorenal syndrome:A systematic review and network meta-analysis[J].Lancet Gastroenterol Hepatol, 2017, 2 (2) :94-102. [22]GIFFORD FJ, MORLING JR, FALLOWFIELD JA.Systematic review with meta-analysis:Vasoactive drugs for the treatment of hepatorenal syndrome type 1[J].Aliment Pharmacol Ther, 2017, 45 (5) :593-603. [23]TUJIOS SR, HYNAN LS, VAZQUEZ MA, et al.Risk factors and outcomes of acute kidney injury in patients with acute liver failure[J].Clin Gastroenterol Hepatol, 2015, 13 (2) :352-359. [24]LI XP, WU ZP, ZHANG LL, et al.Advances in diagnosis and treatment of patients with acute-on-chronic liver failure complicated by acute kidney injury[J].J Clin Hepatol, 2016, 32 (9) :1688-1693. (in Chinese) 李小鹏, 吴振平, 张伦理, 等.慢加急性肝衰竭并发急性肾损伤的诊治进展[J].临床肝胆病杂志, 2016, 32 (9) :1688-1693. [25]CHEN J, LIU XY, TONG JJ, et al.Clinical features of patients with acute/subacute liver failure complicated by acute kidney injury[J].J Clin Hepatol, 2018, 34 (2) :364-367. (in Chinese) 陈婧, 刘晓燕, 童晶晶, 等.急性/亚急性肝衰竭合并急性肾损伤的临床特征分析[J].临床肝胆病杂志, 2018, 34 (2) :364-367. [26]JALAN R, SALIBA F, PAVESI M, et al.Development and validation of a prognostic score to predict mortality in patients with acuteon-chronic liver failure[J].J Hepatol, 2014, 61 (5) :1038-1047. [27]ZANG H, LIU F, LIU H, et al.Incidence, risk factors and outcomes of acute kidney injury (AKI) in patients with acute-onchronic liver failure (ACLF) of underlying cirrhosis[J].Hepatol Int, 2016, 10 (5) :807-818. [28] WU ZP, ZHONG YB, LI XP, et al.The analysis of acute kidney injury in hepatitis B virus related acute-on-chronic liver failure[J].Chin J Infect Dis, 2016, 34 (12) :713-716. (in Chinese) 吴振平, 钟渊斌, 李小鹏, 等.乙型肝炎病毒相关慢加急性 (亚急性) 肝功能衰竭患者中急性肾损伤的分析[J].中华传染病杂志, 2016, 34 (12) :713-716. [29]SHI XX, ZHANG YQ, ZHU P, et al.Prognostic risk factors in patients with acute-on-chronic hepatitis B liver failure[J].J Clin Hepatol, 2016, 32 (4) :700-705. (in Chinese) 石新星, 张艳琼, 朱鹏, 等.乙型肝炎相关慢加急性肝衰竭患者预后的危险因素分析[J].临床肝胆病杂志, 2016, 32 (4) :700-705. [30]JINDAL A, BHADORIA AS, MAIWALL R, et al.Evaluation of acute kidney injury and its response to terlipressin in patients with acute-on-chronic liver failure[J].Liver Int, 2016, 36 (1) :59-67. [31]MAIWALL R, SARIN SK, KUMAR S, et al.Development of predisposition, injury, response, organ failure model for predicting acute kidney injury in acute on chronic liver failure[J].Liver Int, 2017, 37 (10) :1497-1507. [32]YUAN W, ZHANG YY, ZHANG ZG, et al.Risk factors and outcomes of acute kidney injury in patients with hepatitis B virus-related acute-on-chronic liver failure[J].Am J Med Sci, 2017, 353 (5) :452-458. [33]CHEN N, CHEN X, DING X, et al.Analysis of the high incidence of acute kidney injury associated with acute-on-chronic liver failure[J].Hepatol Int, 2018, 12 (3) :262-268.
本文二维码
计量
- 文章访问数: 2224
- HTML全文浏览量: 41
- PDF下载量: 501
- 被引次数: 0