药源性急性肾损伤研究进展.pdfVIP

中国药物警戒第12卷第3期 2015年3月 March,2015,Vol.12,No.3 中图分类号：R994.11 文献标识码：B 文章编号：1672-8629(2015)03-0164-05 药源性急性肾损伤研究进展 1 2 2 2* 1 2 范倩倩 孔旭东 邓昂 唐昆 （北京协和医院药剂科，北京100730；卫生部中日友好医院药学部，北京100029） 巍 摘要：药物作为疾病预防、治疗和诊断的重要手段，也是造成急性肾损伤（AKI）的因素之一。肾毒性药物种类繁多， 可以是单一药物亦可是多种药物联合应用而致病。药源性AKI发病机制多样，以急性肾小管坏死和间质性肾炎为 主。发病的高危因素涉及药物因素（如：药物自身的肾脏毒性、使用剂量与疗程）和患者因素（如：高龄、血容量不足、 慢性肾脏病基础）。本文就临床常见及易忽视的肾毒性药物进行综述，旨在提高对肾毒性药物及发生药源性AKI风 险因素的认知，为临床用药提供参考与警示。 关键词：急性肾损伤；肾毒性药物；发病机制；高危因素 Study Progress of Drug-induced Acute Kidney Injury 1 2 2 2* 1 FAN Qian -qian KONG Xu -dong DENG Ang TANG Kun ( Department of Pharmacy, Peking Union Medical College Hospital, Beijing 100730, China; 2Department of Pharmacy, China-Japan Friendship Hospital, Beijing 100029, China) Abstract: As an important part of disease prevention, treatment and diagnosis, drugs are the common source of acute kidney injury (AKI). There are various kinds of nephrotoxic drugs, and AKI can be induced either by a single drug or combination of several drugs. The main mechanisms of drug-induced AKI include acute tubular necrosis and acute interstitial nephritis. The risk factors involve drug-related factors (such as nephrotoxicity, dosage and duration) and patient-related factors (such as age, hypovolemia, chronic kidney disease). This article is a review of common or unnoticeable nephrotoxic drugs on the purpose of calling for attention to nephrotoxic drugs and AKI risk factors and providing warnings for clinical drug use. Key words: acute kidney injury; nephrotoxic drugs; pathogenesis; risk factors 急性肾损伤（acutekidneyinjury，AKI）是影响肾脏 近年来随着疾病谱的复杂化和联合用药的广泛化，肾毒 结构和功能的疾病状态之一，典型特征为肾功能的急性 性药物也成为导致AKI的重要原因之一，住院患者AKI 减退。2012年改