Critically ill patients with renal protection.docVIP

 PAGE \* MERGEFORMAT 16 Critically ill patients with renal protection Acute renal failure (ARF) is a rapid decline in glomerular filtration rate was characterized as a syndrome. At present the precise definition is still uncertain, because the existing laboratory tests still can not determine sudden changes in renal function. Kidney has a range of functions, including secretion of hormones, regulating acid-base balance and regulate blood pressure. At present, clinical still urine and serum creatinine to monitor kidney function and to guide clinical treatment. While the ARF has made many studies and made some progress, but still a considerable number of causes of morbidity and mortality of patients, its mortality rate remains high. In 2004, the acute dialysis quality and initiated group (Acute Dialysis Quality Initiative (ADQI) Group) under the urine and serum creatinine, raised the definition of critically ill patients with ARF in phases, known as the RIFLE (risk, injure, failure, loss, and end stage) . At 20,000 patients in the retrospective study found that RIFLE be independent predictors of hospital mortality in patients with ARF. Another retrospective study also found that RIFLE predictability of cardiac surgery mortality rates of patients with ARF. RIFLE stage renal failure in the diagnosis of a major step forward, but the early identification of renal dysfunction and provide a valuable treatment still difficult, despite the reports of renal damage in protein bio-indicators (similar to troponin is the indicator of myocardial injury the same) can be found in earlier kidney disease and to provide more timely treatment. At present, the prevention of surgical patients with renal failure is still a lack of specific treatment measures. ARF causes ARF is divided into prerenal, renal, after their own reasons for kidney. Prerenal azotemia is due to absolute or relative lack of renal blood flow, if not treated in time may d