Akute Nierenschädigung

Bereits der Titel dieser Übersichtsarbeit ist vom Herausgeber sehr optimistisch gewählt, denn er suggeriert, dass die akute Nierenschädigung verhindert werden kann. „Akute Nierenschädigung“ ist die seit 2007 einheitliche Definition, die den unterschiedlich auslegbaren Begriff “akutes Nierenversagen” abgelöst hat. Dies erfolgte auch mit der Zielsetzung, in Zukunft möglichst eine geringgradige Schädigung der Niere frühzeitig zu erkennen und dann durch Maßnahmenbündel ein Versagen der Niere verhindern zu können. Leider gibt es bisher keine singuläre pharmakologische oder sonstige Maßnahme die dies zulassen würde, sodass in dieser Übersicht das frühzeitige Erkennen von Nierenschädigungen und die Aufklärung medizinscher Mythen in Bezug auf die akute Nierenschädigung im Mittelpunkt stehen.

The title of this paper is already a bit euphemistic as it implies that prevention of acute kidney injury is indeed possible, which is unfortunately not the case. The uniform definition of acute kidney injury, which was first instituted in 2007 was however choosen to detect injury very early in order to avoid progression to kidney failure, eventually requiring renal replacement therapy. This can however not be done by a magic (pharmacological) bullet by rather by a bundle of measures aimed to predict and diagnose AKI early and to prevent progression to advanced injury or failure. Hence this paper will focus on those measures and will also clarify medical myths in the field of AKI, like the benefit of overhydration in prevention of AKI.

Key words

Prevention - drug toxicity - acute kidney injury - renal replacement therapy

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