Rebecca Barry Matthew T.

James
Department of Medicineand Community Health Sciences,Cumming School for Medicine University of Calgary,
Calgary, Alta., Canada

AKICKD

2012 the Kidney Disease Improving Global Outcomes

2012 AKD
, AKI AKI CKD
AKD

20 2002
KDOQICKDCKD
estimated glomerular filtration rate, eGFR 3
eGFR 5 [1]KDIGO CKD CKD
[2]
AKI2004 Acute
Dialysis Quality Initiative RIFLE
Risk
Injury
Failure
LossEnd-Stage Renal Disease5
[3] 3
2007 Acute Kidney Disease Network[4]2012 KDIGOAKI
[5]

AKI AKI
CKD eGFR
[2,5]


AKI CKD
AKI CKD [6]
[2]
AKI CKD [7]AKI CKD
[2,8]
CKD eGFR CKD
CKD
[9,10] AKI AKI [11]
AKI [12]
CKD AKI [13]
AKI CKD AKI
CKD
AKI CKD
KDIGO 2012 AKI
[2]

AKI CKD
AKI CKD

AKD
AKD AKI GFR<60ml/min/1.73m2
3 3 GFR 35% 3 >50% 1
AKD
1 CKD AKD
AKD 3 GFR
GFR AKD 7 26umol/l
1.5 KDIGO AKI AKI AKD
AKI AKI CKD CKD AKD
AKI 2

AKD
2012 KDIGOAKI AKD KDOQI[7]
(CSN)[8] AKD KDOQI[7] AKD

[7] AKD
AKD KDOQI
AKD

CSNAKD
[8]KDOQICSN
AKD
AKDAKD

Barry/James

 1. [5]NKD=Yes-D=SCr AKD
AKI Yes-I=SCr AKI
1.KDIGO AKICKD AKD

AKI

SCr 7 50%
SCr 2 0.3mg/dl

26.5mol/l
CKD

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AKD

AKI GFR<60ml/min/1.73m2 3

GFR 35%SCr>50% 3

NKD

3 GFR60ml/min/1.73m2 SCr

[5]NKD=

AKD
AKD [14]
AKD Chu [15]
Chu [15]
AKD AKIAKD AKI AKI AKD
AKD AKI AKD
AKI AKD
AKI AKD

 AKI
AKIAKD AKI AKD AKI AKI
AKD AKI 2 (30.8vs.16.0%) AKI
AKD AKI (52.0vs.30.8%) AKI AKD AKI
(28.8vs.29.3%) AKI AKD AKI
AKD AKI
AKD

2. AKICKD AKD AKD AKI CKD AKI CKD

CKD AKI
2. AKD

AKD

AKD
AKI CKD

AKD

AKD AKD AKI

CKD

AKD

CKD
ESRD

AKD CKD AKI

AKD CKD
AKD

AKD
AKD

CKD AKD

AKD

AKD
AKI CKD
4

Barry/James

 AKD

AKD 2
AKD
AKD CKD AKI
AKD AKD

1 Levey S,Coresh J:KDOQI guideline:clinical practice guidelines for chronic kidney disease,evaluation,classification and
stratification.Am J Kidney Dis 2002;39:43100.
2 Kidney Disease:Improving Global Outcomes CKD Work Group:KDIGO 2012 clinical practice guideline for the evaluation and
management of chronic kidney disease.Kidney Int Suppl 2012;3:1150.
3 Bellomo R,Ronco C,Kellum JA,Mehta RL,Palevsky P:Acute renal failuredefinition,outcome measures,animal models,fluid therapy
and information technology needs:the Second International Consensus Conference of the Acute Dialysis Quality
Initiative(ADQI)Group.Crit care 2004;8:R204R212.
4 Mehta RL,Kellum JA,Shah SV,Molitoris BA,Ronco C,Warnock DG,Levin A;Acute Kidney Injury Network:Acute Kidney Injury
Network:report of an initiative to improve outcomes in acute kidney injury.Crit Care 2007;11:R31.
5 Kidney Disease:Improving Global Outcomes AKI Work Group:KDIGO clinical practice guideline for acute kidney injury.Kidney
Int Suppl 2012;2:1138.
6 Levey AS,Levin A,Kellum JA:Definition and classification of kidney diseases.Am J Kidney Dis 2013;61:686688.
7 Palevsky PM,Liu KD,Brophy PD,Chawla LS,Parikh CR,Thakar CV,Tolwani AJ,Waikar SS,Weisbord SD:KDOQI US commentary
on the 2012 KDIGO clinical practice guideline for acute kidney injury.Am J Kidney Dis 2013;61:649672.
8 James M,Bouchard J,Ho J,Klarenbach S,LaFrance JP,Rigatto C,Wald R,Zappitelli M,Pannu N:Canadian society of nephrology
commentary on the 2012 KDIGOclinical practice guideline for acute kidney injury.Am J Kidney Dis 2013;61:673685.
9 Moynihan R,Doust J,Henry D:Preventing overdiagnosis:how to stop harming the healthy.BMJ 2012;344:e3502.
10 Levey AS,de Jong PE,Coresh J,El Nahas M,Astor BC,Matsushita K,Gansevoort RT,Kasiske BL,Eckardt KU:The
definition,classification,and prognosis of chronic kidney disease:a KDIGO controversies conference report.Kidney Int 2011;80:1728.
11 Ricci Z,Cruz D,Ronco C:The RIFLE criteria and mortality in acute kidney injury:asystematic review.Kidney Int 2008;73:538546.
12 Herget-Rosenthal S,Marggraf G,Hsing J,Gring F,Pietruck F,Janssen O,Philipp T,Kribben A:Early detection of acute renal failure
by serum cystatin C.Kidney Int 2004;66:11151122.
13 Waikar SS,Bonventre JV:Creatinine kinetics and the definition of acute kidney injury.J Am Soc Nephrol 2009;20:672679.
14 Levey AS,Becker C,Inker LA:Glomerular filtration rate and albuminuria for detection and staging of acute and chronic kidney
disease in adults:a systematic review.JAMA 2015;313:837846.
15 Chu R,Li C,Wang S,Zou W,Liu G,Yang L:Assessment of KDIGO definitions in patients with histopathologic evidence of acute
renal disease.Clin J Am Soc Nephrol 2014;9:11751182.

http://group.medlive.cn/topic/92419

Barry/James