Острое повреждение почек: концептуальные проблемы

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.

острое повреждение почек, концепция, определения, классификации, эпидемиология, исходы

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