2012年 KDIGO-AKI诊疗指南解读.pptVIP

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2012年 KDIGO-AKI诊疗指南解读.ppt

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About AKI guideline ADQI：2002, RIFLE AKIN：2005, modified definition and staging system KDIGO: 2011, First clinical guideline for AKI Waiting for published in this summer AKI guideline for AKI :2011 UK Renal Association Final Version 08.03.11 AKI guidline—KDIGO 2012 KDIGO Clinical Practice Guideline for Acute Kidney Injury AKI流行病学现状患病率：1%（社区）~ 7.1%（医院）人群发病率：486~630 pmp/y AKI需要RRT发病率：22~203pmp/y 医院获得AKI死亡率：10~80% 合并多脏器功能衰竭死亡率：50% 需要RRT治疗者死亡率：高达80% 指南推荐强度 RIFLE分级 Chapter 2.2: Risk assessment Chapter 2.2: Risk assessment ?AKI is defined as any of the following (Not Graded ): ·AKI is defined as any of the following (Not Graded ): KIncrease in SCr by X 0.3 mg/dl ( X26.5 lmol/l)within 48 hours; ·or KIncrease in SCr to X1.5 times baseline, whichis known or presumed to have occurred withinthe prior 7 days; ·orKUrine volume o0.5 ml/kg/h for 6 hours.?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 )? Evaluate patients with AKI promptly to determine the cause, with special attention to reversible causes.(Not Graded ) ? he cause of AKI should be determined whenever possible. (Not Graded) Overview of AKI, CKD, and AKD. Overlapping ovals show the relationships among AKI, AKD, and CKD. AKI is a subset of AKD. Both AKI and AKD without AKI can be superimposed upon CKD. Individuals without AKI, AKD, or CKD have no known kidney disease (NKD), not shown here. AKD, acute kidney diseases and disorders; AKI, acute kidney injury; CKD, chronic kidney disease. AKDacute kidney diseases and disorder 符合以下任何一项 AKI, 符合AKI定义 3个月内在原来基础上，GFR下降35%或Scr上升50% GFR60ml/min/1.73m2, 3个月肾损伤3个月 AKI/CKD/AKD Stage-based management of AKI 补液治疗 In the absence of hemorrhagic shock, we suggest using isotonic crystalloids rather than colloids (albumin orstarches) as initial management for expansion ofintravascular vo