Острое повреждение почек: концептуальные проблемы
Аннотация
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.
Ключевые слова
Об авторах
А. В. Смирнов
Научно-исследовательский институт нефрологии; Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова
Россия
Россия
И. Г. Каюков
Научно-исследовательский институт нефрологии; Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова
Россия
Россия
В. А. Добронравов
Научно-исследовательский институт нефрологии; Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова
Россия
Россия
А. Ш. Румянцев
Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова
Россия
Россия
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Для цитирования:
Смирнов А.В., Каюков И.Г., Добронравов В.А., Румянцев А.Ш. Острое повреждение почек: концептуальные проблемы. Нефрология. 2014;18(2):8-24.
For citation:
Smirnov A.V., Kayukov I.G., Dobronravov V.A., Rumyantsev A.S. Acute kidney injury: conceptual problems. Nephrology (Saint-Petersburg). 2014;18(2):8-24. (In Russ.)
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