Detektion und Differenzialdiagnose des ANV in der Intensivmedizin

ZUSAMMENFASSUNG

Das akute Nierenversagen (ANV) in der Intensivmedizin ist typischerweise die Folge einer schweren Minderperfusion der Nieren, welche nach Ereignissen wie Sepsis, Trauma oder großen Operationen auftritt. Davon abzugrenzen sind seltenere ANV-Formen wie Glomerulonephritiden, interstitielle Nephritiden oder thrombotische Mikroangiopathien, für die es spezifische Therapieoptionen gibt. Abhängig von der Komorbidität des Patienten, geht das Krankheitsbild zumeist mit multiplen Organdysfunktionen einher und zeigt komplikationsreiche Verläufe mit einer hohen Mortalität. Der Einsatz neuer Biomarker ermöglicht ein früheres und sensitiveres Erkennen einer Nierenfunktionsstörung und/oder einer Nierenschädigung. Für die ANV-Diagnose gilt jedoch weiterhin die etablierte Definition nach den KDIGO-Kriterien.

• Literatur

• 1 Ostermann ME, Taube D, Morgan CJ, Evans TW. Acute renal failure following cardiopulmonary bypass: a changing picture. Intensive Care Med 2000; 26: 565-571 doi:10.1007/s001340051205
• 2 Chertow GM, Burdick E, Honour M. et al Acute kidney injury, mortality, length of stay, and costs in hospitalized patients. J Am Soc Nephrol 2005; 16: 3365-3370 doi:10.1681/ASN.2004090740
• 3 Kellum JA, Levin N, Bouman C, Lameire N. Developing a consensus classification system for acute renal failure. Curr Opin Crit Care 2002; 8: 509-514
• 4 KDIGO AKI Work Group KDIGO clinical practice guideline for acute kidney injury. Kidney Int Suppl 2012; 2: 1-138
• 5 Liborio AB, Leite TT, Neves FM. et al AKI complications in critically ill patients: association with mortality rates and RRT. Clin J Am Soc Nephrol 2015; 10: 21-28 doi:10.2215/CJN.04750514
• 6 Hoste EA, Bagshaw SM, Bellomo R. et al Epidemiology of acute kidney injury in critically ill patients: the multinational AKI-EPI study. Intensive Care Med 2015; 41: 1411-1423 doi:10.1007/s00134-015-3934-7
• 7 Kellum JA, Sileanu FE, Murugan R. et al Classifying AKI by Urine Output versus Serum Creatinine Level. J Am Soc Nephrol 2015; 26: 2231-2238 doi:10.1681/ASN.2014070724
• 8 Fortrie G, de Geus HRH, Betjes MGH. The aftermath of acute kidney injury: a narrative review of long-term mortality and renal function. Crit Care 2019; 23: 24 doi:10.1186/s13054-019-2314-z
• 9 Giordana F, D’Ascenzo F, Nijhoff F. et al Meta-analysis of predictors of all-cause mortality after transcatheter aortic valve implantation. Am J Cardiol 2014; 114: 1447-1455 doi:10.1016/j.amjcard.2014.07.081
• 10 Mao H, Katz N, Ariyanon W. et al Cardiac surgery-associated acute kidney injury. Cardiorenal Med 2013; 3: 178-199 doi:10.1159/000353134
• 11 Lai CF, Wu VC, Huang TM. et al Kidney function decline after a non-dialysis-requiring acute kidney injury is associated with higher long-term mortality in critically ill survivors. Crit Care 2012; 16: R123 doi:10.1186/cc11419
• 12 Brown JR, Parikh CR, Ross CS. et al Impact of perioperative acute kidney injury as a severity index for thirty-day readmission after cardiac surgery. Ann Thorac Surg 2014; 97: 111-117 doi:10.1016/j.athoracsur.2013.07.090
• 13 Sawhney S, Marks A, Fluck N. et al Intermediate and Long-term Outcomes of Survivors of Acute Kidney Injury Episodes: A Large Population-Based Cohort Study. Am J Kidney Dis 2017; 69: 18-28 doi:10.1053/j.ajkd.2016.05.018
• 14 See EJ, Jayasinghe K, Glassford N. et al Long-term risk of adverse outcomes after acute kidney injury: a systematic review and meta-analysis of cohort studies using consensus definitions of exposure. Kidney Int 2019; 95: 160-172 doi:10.1016/j.kint.2018.08.036
• 15 Gocze I, Schlitt HJ, Bergler T. Biomarker-guided Intervention to Prevent AKI or KDIGO Care Bundle to Prevent AKI in High-risk Patients Undergoing Major Surgery?. Ann Surg 2018; 268: e68-e69 doi:10.1097/SLA.0000000000002635
• 16 Hobson C, Ozrazgat-Baslanti T, Kuxhausen A. et al Cost and Mortality Associated With Postoperative Acute Kidney Injury. Ann Surg 2015; 261: 1207-1214 doi:10.1097/SLA.0000000000000732
• 17 Mehta RL, Pascual MT, Soroko S. et al Spectrum of acute renal failure in the intensive care unit: the PICARD experience. Kidney Int 2004; 66: 1613-1621 doi:10.1111/j.1523-1755.2004.00927.x
• 18 Santos WJ, Zanetta DM, Pires AC. et al Patients with ischaemic, mixed and nephrotoxic acute tubular necrosis in the intensive care unit--a homogeneous population?. Crit Care 2006; 10: R68 doi:10.1186/cc4904
• 19 Liano F, Pascual J. Epidemiology of acute renal failure: a prospective, multicenter, community-based study. Madrid Acute Renal Failure Study Group. Kidney Int 1996; 50: 811-818 doi:10.1038/ki.1996.380
• 20 Guder WG, Ross BD. Enzyme distribution along the nephron. Kidney Int 1984; 26: 101-111 doi:10.1038/ki.1984.143
• 21 Brealey D, Brand M, Hargreaves I. et al Association between mitochondrial dysfunction and severity and outcome of septic shock. Lancet 2002; 360: 219-223 doi:10.1016/S0140-6736(02)09459-X
• 22 Carre JE, Orban JC, Re L. et al Survival in critical illness is associated with early activation of mitochondrial biogenesis. Am J Respir Crit Care Med 2010; 182: 745-751 doi:10.1164/rccm.201003-0326OC
• 23 Carlstrom M, Wilcox CS, Arendshorst WJ. Renal autoregulation in health and disease. Physiol Rev 2015; 95: 405-511 doi:10.1152/physrev.00042.2012
• 24 Verma SK, Molitoris BA. Renal endothelial injury and microvascular dysfunction in acute kidney injury. Semin Nephrol 2015; 35: 96-107 doi:10.1016/j.semnephrol.2015.01.010
• 25 Meola M, Nalesso F, Petrucci I. et al Clinical Scenarios in Acute Kidney Injury: Pre-Renal Acute Kidney Injury. Contrib Nephrol 2016; 188: 21-32 doi:10.1159/000445462
• 26 Thadhani R, Pascual M, Bonventre JV. Acute renal failure. N Engl J Med 1996; 334: 1448-1460 doi:10.1056/NEJM199605303342207
• 27 Herget-Rosenthal S, Hosford M, Kribben A. et al Characteristics of EYFP-actin and visualization of actin dynamics during ATP depletion and repletion. Am J Physiol Cell Physiol 2001; 281: C1858-C1870 doi:10.1152/ajpcell.2001.281.6.C1858
• 28 Molitoris BA, Sutton TA. Endothelial injury and dysfunction: role in the extension phase of acute renal failure. Kidney Int 2004; 66: 496-499 doi:10.1111/j.1523-1755.2004.761_5.x
• 29 Knaus WA, Draper EA, Wagner DP. et al APACHE II: a severity of disease classification system. Crit Care Med 1985; 13: 818-829
• 30 Knaus WA, Wagner DP, Draper EA. et al The APACHE III prognostic system. Risk prediction of hospital mortality for critically ill hospitalized adults. Chest 1991; 100: 1619-1636 doi:10.1378/chest.100.6.1619
• 31 Le JR Gall, Lemeshow S, Saulnier F. A new Simplified Acute Physiology Score (SAPS II) based on a European/North American multicenter study. JAMA 1993; 270: 2957-2963 doi:10.1001/jama.270.24.2957
• 32 Metnitz PG, Moreno RP, Almeida E. et al SAPS 3 – From evaluation of the patient to evaluation of the intensive care unit. Part 1: Objectives, methods and cohort description. Intensive Care Med 2005; 31: 1336-1344 doi:10.1007/s00134-005-2762-6
• 33 Lemeshow S, Teres D, Klar J. et al Mortality Probability Models (MPM II) based on an international cohort of intensive care unit patients. JAMA 1993; 270: 2478-2486
• 34 Higgins TL, Teres D, Copes WS. et al Assessing contemporary intensive care unit outcome: an updated Mortality Probability Admission Model (MPM0-III). Crit Care Med 2007; 35: 827-835 doi:10.1097/01.CCM.0000257337.63529.9F
• 35 Cao Z, Jia Y, Zhu B. BNP and NT-proBNP as Diagnostic Biomarkers for Cardiac Dysfunction in Both Clinical and Forensic Medicine. Int J Mol Sci 2019: 20 pii: E1820. doi:10.3390/ijms20081820
• 36 Januzzi JL, van Kimmenade R, Lainchbury J. et al NT-proBNP testing for diagnosis and short-term prognosis in acute destabilized heart failure: an international pooled analysis of 1256 patients: the International Collaborative of NT-proBNP Study. Eur Heart J 2006; 27: 330-337 doi:10.1093/eurheartj/ehi631
• 37 Ferguson ND, Fan E, Camporota L. et al The Berlin definition of ARDS: an expanded rationale, justification, and supplementary material. Intensive Care Med 2012; 38: 1573-1582 doi:10.1007/s00134-012-2682-1
• 38 Rubin TM, Heyne K, Luchterhand A. et al Kinetic validation of the LiMAx test during 10 000 intravenous (13)C-methacetin breath tests. J Breath Res 2017; 12: 016005 doi:10.1088/1752-7163/aa820b
• 39 Havasi A, Borkan SC. Apoptosis and acute kidney injury. Kidney Int 2011; 80: 29-40 doi:10.1038/ki.2011.120
• 40 Kelly KJ. Distant effects of experimental renal ischemia/reperfusion injury. J Am Soc Nephrol 2003; 14: 1549-1558 doi:10.1097/01.asn.0000064946.94590.46
• 41 Kinsey GR, Li L, Okusa MD. Inflammation in acute kidney injury. Nephron Exp Nephrol 2008; 109: e102-e107 doi:10.1159/000142934
• 42 Feltes CM, Van Eyk J, Rabb H. Distant-organ changes after acute kidney injury. Nephron Physiol 2008; 109: p80-p84 doi:10.1159/000142940
• 43 Bellomo R, Ronco C, Kellum JA. et al Acute renal failure – definition, 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: R204-212 doi:10.1186/cc2872
• 44 Ronco C. Acute kidney injury: from clinical to molecular diagnosis. Critical Care 2016; 20: 201 doi:10.1186/s13054-016-1373-7
• 45 Mehta RL, Kellum JA, Shah SV. et al Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care 2007; 11: R31 doi:10.1186/cc5713
• 46 Kim H, Hur M, Cruz DN. et al Plasma neutrophil gelatinase-associated lipocalin as a biomarker for acute kidney injury in critically ill patients with suspected sepsis. Clin Biochem 2013; 46: 1414-1418 doi:.1016/j.clinbiochem.2013.05.069
• 47 Hoste EA, McCullough PA, Kashani K. et al Derivation and validation of cutoffs for clinical use of cell cycle arrest biomarkers. Nephrol Dial Transplant 2014; 29: 2054-2061 doi:10.1093/ndt/gfu292
• 48 Gunnerson KJ, Shaw AD, Chawla LS. et al TIMP2*IGFBP7 biomarker panel accurately predicts acute kidney injury in high-risk surgical patients. J Trauma Acute Care Surg 2016; 80: 243-249 doi:10.1097/TA.0000000000000912
• 49 Vijayan A, Faubel S, Askenazi DJ. et al Clinical Use of the Urine Biomarker [TIMP-2] × [IGFBP7] for Acute Kidney Injury Risk Assessment. Am J Kidney Dis 2016; 68: 19-28 doi:10.1053/j.ajkd.2015.12.033
• 50 Kashani K, Al-Khafaji A, Ardiles T. et al Discovery and validation of cell cycle arrest biomarkers in human acute kidney injury. Crit Care 2013; 17: R25 doi:10.1186/cc12503
• 51 de Geus HR, Ronco C, Haase M. et al The cardiac surgery-associated neutrophil gelatinase-associated lipocalin (CSA-NGAL) score: A potential tool to monitor acute tubular damage. J Thorac Cardiovasc Surg 2016; 151: 1476-1481 doi:10.1016/j.jtcvs.2016.01.037
• 52 Schunk SJ, Zarbock A, Meersch M. et al Association between urinary dickkopf-3, acute kidney injury, and subsequent loss of kidney function in patients undergoing cardiac surgery: an observational cohort study. Lancet 2019; 394: 488-496 doi:10.1016/S0140-6736(19)30769-X
• 53 Ronco C. Acute kidney injury: from clinical to molecular diagnosis. Crit Care 2016; 20: 201 doi:10.1186/s13054-016-1373-7
• 54 Han SS, Ahn SY, Ryu J. et al Proteinuria and hematuria are associated with acute kidney injury and mortality in critically ill patients: a retrospective observational study. BMC Nephrol 2014; 15: 93 doi:10.1186/1471-2369-15-93
• 55 Dickson LE, Wagner MC, Sandoval RM. et al The proximal tubule and albuminuria: really!. J Am Soc Nephrol 2014; 25: 443-453 doi:10.1681/ASN.2013090950
• 56 Parikh CR, Lu JC, Coca SG. et al Tubular proteinuria in acute kidney injury: a critical evaluation of current status and future promise. Ann Clin Biochem 2010; 47: 301-312 doi:10.1258/acb.2010.010076
• 57 Jennette JC, Nachman PH. ANCA Glomerulonephritis and Vasculitis. Clin J Am Soc Nephrol 2017; 12: 1680-1691 doi:10.2215/cjn.02500317
• 58 Praga M, Sevillano A, Aunon P. et al Changes in the aetiology, clinical presentation and management of acute interstitial nephritis, an increasingly common cause of acute kidney injury. Nephrol Dial Transplant 2015; 30: 1472-1479 doi:10.1093/ndt/gfu326
• 59 Perazella MA. Diagnosing drug-induced AIN in the hospitalized patient: a challenge for the clinician. Clin Nephrol 2014; 81: 381-388 doi:10.5414/cn108301
• 60 Muriithi AK, Nasr SH, Leung N. Utility of urine eosinophils in the diagnosis of acute interstitial nephritis. Clin J Am Soc Nephrol 2013; 8: 1857-1862 doi:10.2215/CJN.01330213
• 61 Levy GG, Nichols WC, Lian EC. et al Mutations in a member of the ADAMTS gene family cause thrombotic thrombocytopenic purpura. Nature 2001; 413: 488-494 doi:10.1038/35097008
• 62 Buchholz U, Bernard H, Werber D. et al German outbreak of Escherichia coli O104:H4 associated with sprouts. N Engl J Med 2011; 365: 1763-1770 doi:10.1056/NEJMoa1106482
• 63 Noris M, Caprioli J, Bresin E. et al Relative role of genetic complement abnormalities in sporadic and familial aHUS and their impact on clinical phenotype. Clin J Am Soc Nephrol 2010; 5: 1844-1859 doi:10.2215/CJN.02210310
• 64 Clark WF. Thrombotic microangiopathy: current knowledge and outcomes with plasma exchange. Semin Dial 2012; 25: 214-219 doi:10.1111/j.1525-139X.2011.01035.x
• 65 Legendre CM, Licht C, Muus P. et al Terminal complement inhibitor eculizumab in atypical hemolytic-uremic syndrome. N Engl J Med 2013; 368: 2169-2181 doi:10.1056/NEJMoa1208981
• 66 Froissart A, Buffet M, Veyradier A. et al Efficacy and safety of first-line rituximab in severe, acquired thrombotic thrombocytopenic purpura with a suboptimal response to plasma exchange. Experience of the French Thrombotic Microangiopathies Reference Center. Crit Care Med 2012; 40: 104-111 doi:10.1097/CCM.0b013e31822e9d66
• 67 Lameire N, Vanholder R, Van Biesen W. et al Acute kidney injury in critically ill cancer patients: an update. Crit Care 2016; 20: 209 doi:10.1186/s13054-016-1382-6
• 68 Petejova N, Martinek A. Acute kidney injury due to rhabdomyolysis and renal replacement therapy: a critical review. Crit Care 2014; 18: 224 doi:10.1186/cc13897
• 69 Bienholz A, Wilde B, Kribben A. From the nephrologist’s point of view: diversity of causes and clinical features of acute kidney injury. Clin Kidney J 2015; 8: 405-414 doi:10.1093/ckj/sfv043