KDIGO急性肾损伤指南解读.ppt

Microbiological quality standards of different regulatory agencies RRT剂量 The dose of RRT to be delivered should be prescribed before starting each session of RRT. (Not Graded) We recommend frequent assessment of the actual delivered dose in order to adjust the prescription. (1B) Provide RRT to achieve the goals of electrolyte, acid-base, solute, and fluid balance that will meet the patient’s needs. (Not Graded) RRT剂量 We recommend delivering a Kt/V of 3.9 per week when using intermittent or extended RRT in AKI. (1A) We recommend delivering an effluent volume of 20–25 ml/kg/h for CRRT in AKI (1A). This will usually require a higher prescription of effluent volume. (Not Graded) 谢谢! 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 未分级26条29.9% 2级39条63.9% 1级22条36.1% 1A:9 14.8% 1B:10 16.4% 1C:3 4.9% 2A:2 3.3% 2B:10 16.4% 2C:20 32.8% 2D:7 11.5% 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 ≥0.3 mg/dl (≥ 26.5 lmol/l) within 48 hours 2. Increase in SCr to ≥ 1.5 times baseline, which is known or presumed to have occurred within the prior 7 days 3. Urine volume 0.5 ml/kg/h for 6 hours. AKI 诊断(Not Graded) Stage Serum creatinine Urine output 1 1.5–1.9 times baseline OR 0.5 ml/kg/h for ≥0.3 mg/dl (≥ 26.5 mmol/l) increase 6–12 hours 2 2.0–2.9 times baseline 0.5 ml/kg/h for ≥12 hours 3 3.0 times baseline OR Increase in serum creatinine to 0.3 ml/kg/h for