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중환자의 급성 신손상

Acute Kidney Injury in Critically Ill Patients

이은경|장재원
대한내과학회 (The Korean Association Of Internal Medicine)|2015.04|대한내과학회지 (The Korean Journal of Medicine)|제88권 제4호|pp. 369-374|DOI http://dx.doi.org/10.3904/kjm.2015.88.4.369

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참고문헌

키워드

Acute kidney injuryRenal replacement therapy급성 신손상신대치 요법
주제분류내과학

초록

신부전증은 신기능이 감소된 상태를 말하며 집중 치료를받는 중환자의 경우 신부전증이 동반되면 사망률이 증가함은 잘 알려진 사실이다. 심장 수술을 받은 4,118명의 코호트연구에서 수술 후 48시간 내에 혈청 크레아티닌의 증가 폭이 클수록 30일 사망률이 증가한다는 보고와 중증의 패혈증 환자에서 혈청 크레아티닌의 초기 값이 높을수록 사망률이 증가하며, 정상 범위를 벗어나는 경우 치료에 의해 혈청크레아티닌 농도가 정상 범위로 이동할수록 사망률이 낮아진다는 연구 결과 등을 생각해 보면, 신기능의 변화는 환자의 예후에 직접적인 영향을 미친다고 할 수 있다. 그러므로 중환자의 치료에 있어 신부전증의 발생을 예방하는 것은물론, 신부전증이 발생한 경우 조기에 발견하여 치료하는 것은 매우 중요할 것이다.

Abstract

Despite substantial advances in dialysis techniques and machines, acute kidney injury (AKI) requiring renal replacement therapy(RRT) is still associated with up to 60% in-hospital mortality. However, there is little information on whether RRT overcomes thesignificant morbidity and mortality of AKI. What is most important in the treatment of AKI is that RRT is not a cause-specific therapybut life-supportive management. This review discusses the indications of, proper initiation of, and optimal prescription for RRTto improve the survival of critically ill patients with AKI.

참고문헌 (29)

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관련 논문AI추천

중환자실 재원 중 발생한 급성 신손상의 위험인자 평가최선, 나현오, 안서현, 안혜림, 황보신이한국병원약사회 · 병원약사회지2019 · 제36권 제3호급성신손상의 원인과 치료오세원대한내과학회 · 대한내과학회지2019 · 제94권 제4호패혈증성 쇼크환자에서 지속적 신대체요법 시작시기와 예후와의 관계고윤석, 김원영, 유승목, 임채만, 최상식, 허진원, 홍상범대한중환자의학회 · Acute and Critical Care2012 · 제27권 제1호The Risk Factors and Outcome of Acute Kidney Injury in the Intensive Care Units김현철, 박성배, 박우영, 장미현, 황은아대한내과학회 · The Korean Journal of Internal Medicine2010 · 제25권 제2호Continuous renal replacement therapy for the treatment of acute kidney injury김남호, 김수완, 마성권, 배은희, 최기철, Dae Hun Lim, Hae Young Jung, Jeong Woo Park, Ji Min Jeong, Seong Ku Kim, Woo Kyun Bae대한내과학회 · The Korean Journal of Internal Medicine2008 · 제23권 제2호급성 신손상의 정의와 진단 기준남궁미경대한소아신장학회 · Childhood Kidney Diseases2011 · 제15권 제2호

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