KDIGOAKI急性肾损伤诊疗指南解读版.pptVIP

Growth factor intervention We recommend not using recombinant human (rh)IGF-1 to prevent or treat AKI. （1B） human IGF-1：重组人胰岛素样生长因子1 * 学习文档 Prevention of aminoglycoside- andamphotericin-related AKI We suggest not using aminoglycosides for the treat-ment of infections unless no suitable, less nephro-toxic, therapeutic alternatives are available. (2A) We suggest that, in patients with normal kidney function in steady state, aminoglycosides are administered as a single dose daily rather than multiple-dose daily treatment regimens. (2B) We recommend monitoring aminoglycoside drug levels when treatment with multiple daily dosing is used for more than 24 hours. (1A) We suggest monitoring aminoglycoside drug levels when treatment with single-daily dosing is used for more than 48 hours. (2C) We suggest using topical or local applications of aminoglycosides (e.g., respiratory aerosols, instilled antibiotic beads), rather than i.v. application, when feasible and suitable. ( 2B) * 学习文档 Prevention of aminoglycoside- andamphotericin-related AKI We suggest using lipid formulations of ampho-tericin B rather than conventional formulations of amphotericin B. (2A) In the treatment of systemic mycoses or parasitic infections, we recommend using azole antifungal agents and/or the echinocandins rather than conventional amphotericin B, if equal therapeutic efficacy can be assumed.(1A) * 学习文档 Guidline We suggest that off-pump coronary artery bypass graft surgery not be selected solely for the purpose of reducing perioperative AKI or need for RRT. (2C) We suggest not using NAC to prevent AKI in critically ill patients with hypotension. (2D) We recommend not using oral or i.v. NAC for prevention of postsurgical AKI. (1A) * 学习文档 Guidline Initiate RRT emergently when life-threatening changes in ?uid, electrolyte, and acid-base balance exist.(Not Graded) Consider the broader clinical context, the presence of conditions that can be modi?ed with RRT, and trends of laboratory tests—rather tha