References

nefr

Нефрология

Nephrology (Saint-Petersburg)

1561-62742541-9439

Pavlov First Saint-Petersburg State Medical University

nefr-11

Research Article

ПЕРЕДОВАЯ СТАТЬЯ

LEADING ARTICLE

Острое повреждение почек: концептуальные проблемы

Acute kidney injury: conceptual problems

Смирнов

А. В.

Smirnov

A. V.

noemail@neicon.ru

Каюков

И. Г.

Kayukov

I. G.

kaukov@nephrolog.ru

Добронравов

В. А.

Dobronravov

V. A.

noemail@neicon.ru

Румянцев

А. Ш.

Rumyantsev

A. Sh.

noemail@neicon.ru

Научно-исследовательский институт нефрологии; Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. ПавловаRussian FederationПервый Санкт-Петербургский государственный медицинский университет им. акад. И.П. ПавловаRussian Federation

2014

01032014

182824

2014

Смирнов А.В., Каюков И.Г., Добронравов В.А., Румянцев А.Ш.

Smirnov A.V., Kayukov I.G., Dobronravov V.A., Rumyantsev A.S.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://journal.nephrolog.ru/jour/article/view/11

Термин «острое повреждение почек» (ОПП) пришел на смену старому термину «острая почечная недостаточность» (ОПН). Данная замена продиктована рядом мотивов, в том числе попыткой унифицировать критерии диагностики и стратификации тяжести острого поражения/дисфункции почек. Рассмотрены преимущества и недостатки современных классификационных схем ОПП. Однако они отражают не только «повреждение», но и «недостаточность» органа. Среди перспективных подходов, позволяющих оптимизировать классификацию, обсуждается выделение стадии (или дополнения I стадии ОПП) преходящим выявлением биомаркеров ОПП, использование при стратификации тяжести данного состояния не относительных, а абсолютных изменений концентрации сывороточного креатинина (Scr), отказ от критериев, основанных на изменениях объема мочи. Вопросы классификации ОПП актуальны, так как данное состояние широко распространено, остается важной причиной формирования и/или прогрессирования хронической болезни почек, считается важным детерминантом кардиоваскулярного риска.

Term «acute kidney injury» (AKI) replaced earlier term «acute kidney failure» (AKF). This replacement was determined by a number of reasons including an effort to unify criteria of diagnostics and stratification of severity of acute injury/kidney failure. Advantages and disadvantages of modern AKI classification systems were observed. However they indicate not only «injury» but also organ «failure». Among prospective approaches which provide optimization of classification there are discussed: stage separation (or AKI first stage addition) by transient revelation of AKI biomarkers, at stratification of severity of this state use not relative but absolute variations of serum creatinine concentration (Scr), refusal of criteria based on urinary volume change. AKI classification questions are important because this state is wide-spread, is still significant reason of formation and/or progression of chronic kidney disease, is considered to be important determinant of cardiovascular risk.

острое повреждение почекконцепцияопределенияклассификацииэпидемиологияисходы

acute kidney injuryconceptiondefinitionsclassificationepidemiologyclassificationoutcomes

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The authors declare that there are no conflicts of interest present.