KDIGO-AI急性肾损伤诊疗指南解读2017版.pptVIP

About AKI guideline ADQI：2002, RIFLE AKIN：2005, modified definition and staging system KDIGO: 2011, First clinical guideline for AKI Waiting for published in this summer AKI guideline for AKI :2011 UK Renal Association Final Version 08.03.11 AKI guidline—KDIGO 2012 KDIGO Clinical Practice Guideline for Acute Kidney Injury 指南推荐强度 AKI is de?ned as any of the following (Not Graded): Increase in SCr by 0.3mg/dl (X26.5 mol/l) within 48 hours; or Increase in SCr to1.5 times baseline, which is known or presumed to have occurred within the prior 7 days; or Urine volume 0.5ml/kg/h for 6 hours. Chapter 2.2: Risk assessment Chapter 2.2: Risk assessment Overview of AKI, CKD, and AKD. Overlapping ovals show the relationships among AKI, AKD, and CKD. AKI is a subset of AKD. Both AKI and AKD without AKI can be superimposed upon CKD. Individuals without AKI, AKD, or CKD have no known kidney disease (NKD), not shown here. AKD, acute kidney diseases and disorders; AKI, acute kidney injury; CKD, chronic kidney disease. AKI/CKD/AKD Stage-based management of AKI Guidline 3 In the absence of hemorrhagic shock, we suggest using isotonic crystalloids rather than colloids (albumin orstarches) as initial management for expansion of intravascular volume in patients at risk for AKI or with AKI. (2B) We recommend the use of vasopressors in conjunction with fluids in patients with vasomotor shock with, or at risk for AKI. ( 1C) We suggest using protocol-based management of hemodynamic and oxygenation parameters to prevent development or worsening of AKI in high-risk patients in the perioperative setting (2C) or in patients with septic shock (2C) Chapter 3.4: The use of diuretics in AKI We recommend not using diuretics to prevent AKI. (1B) We suggest not using diuretics to treat AKI, exceptin the management of volume overload. ( 2C) The use of diuretics in AKI At present, the current evidence does not suggest that furosemide can reduce mortality in patients with AKI. Mannitol is not scientif