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DOI: 10.1055/s-2003-39458
Das akute Nierenversagen - Eine Übersicht
Acute renal failure - an updatePublication History
eingereicht: 14.1.2003
akzeptiert: 17.4.2003
Publication Date:
28 May 2003 (online)
Das akute Nierenversagen (ANV) ist definiert als ein rascher, sich über Stunden bis Tage entwickelnder Abfall der Nierenfunktion, erfasst anhand der glomerulären Filtrationsrate (GFR) [53]. Andere Aspekte der Nierenfunktion, wie die Ausscheidung weiterer Stoffwechselendprodukte und Medikamente, die Rückresorption filtrierter Substanzen, die Regulation des Elektrolyt- und Säuren-Basen-Haushalts und die verschiedenen endokrinen Funktionen sind beim ANV ebenfalls beeinträchtigt. Sie werden aber zum Nachweis und zur Bestimmung der Schwere des ANV nicht herangezogen, weil sie bezogen auf die Nierenfunktion derzeit nur schlecht quantifizierbar sind. Ein Nachlassen der Urinproduktion ist zwar häufig der erste Hinweis auf ein ANV, doch kann die Urinmenge beim ANV auch normal oder sogar gesteigert sein. Es werden derzeit über 35 verschiedene Definitionen des ANV verwendet. Dies erschwert den Vergleich zwischen den Aussagen verschiedener Studien zur Epidemiologie, zum Krankheitsrisiko, zur Prognose und zur Prävention des ANV [27]. Die „Acute Dialysis Quality Initiative” (ADQI) diskutiert derzeit eine Vereinheitlichung der Definitionen mit einer Einteilung des ANV nach den so genannten RIFLE-Kriterien (www.ADQI.net) (Tab. [1]).
Literatur
- 1 Anderson R J, Linas S L, Berns A S, Henrich W L, Miller T R, Gabow P A, Schrier R W. Nonoliguric acute renal failure. N Engl J Med. 1977; 296 1134-1138
- 2 Atkinson S J, Molitoris B A. Cytoskeletal alterations as a basis of cellular injury in acute renal failure. Philadelphia, WB Saunders A Companion to Bernner & RectorŽs The Kidney, edited by Molitoris BA, Finn WP 2001: 119-131
- 3 Badr K F, Ichikawa I. Prerenal failure: A deleterious shift from renal compensation to decompensation. N Engl J Med. 1988; 319 623-629
- 4 Berger E D, Bader B D, Rösker T, Risler T, Erley C M. Kontrastmittelinduziertes Nierenversagen lässt sich durch Hämodialyse nicht verhindern. Dtsch Med Wochenschr. 2001; 126 162-166
- 5 Better O S, Rubinstein I. Post-traumatic acute renal failure with emphasis on the muscle crush syndrome. Philadelphia, WB Saunders A Companion to Bernner & RectorŽs The Kidney, edited by Molitoris BA, Finn WP 2001: 227-235
- 6 Bhandari S, Turney J H. Survivors of acute renal failure who do not recover renal function. QJM. 1996; 89 415-421
- 7 Bradley A B. Factors affecting kidney transplantation success. Curr Opin Nephrol Hypertens. 1992; 1 220-229
- 8 Brady H R, Singer G G. Acute renal failure. Lancet. 1995; 346 1533-1540
- 9 Brown C D, Ogg C S, Cameron J S. High dose furosemide in acute renal failure: a controlled trial. Clin Nephrol. 1981; 15 90-96
- 10 Carvounis C, Nisar S, Guro-Razuman S. Significance of the fractional excretion of urea in the differential diagnosis of acute renal failure. Kidney Int. 2002; 62 2223-2229
- 11 Chan L, Kam I. Outcomes and complications of renal transplantation. Boston, New York, Toronto, London: Little, Brown and Company Diseases of the kidney, 6th ed., edited by Schrier RW, Gottschalk CW 1996 Vol. III: 2713-2769
- 12 Chertow G M, Levy E M, Hammermeister K E, Grover F, Daley J. Independent association between acute renal failure and mortality following cardiac surgery. Am J Med. 1998; 104 343-348
- 13 Conger J D. Vascular alterations in acute renal failure: roles in initiation and maintenance. Acute renal failure. Philadelphia, WB Saunders A Companion to Brenner& RectorŽs The Kidney, edited by Molitoris BA, Finn 2001: 13-29
- 14 Durham J D, Caputo C, Dokko J, Zaharakis T, Pahlavan M, Keltz J, Dutka P, Marzo K, Maesaka J K, Fishbane S. A randomised controlled trial of N-acetylcysteine to prevent contrast nephropathy in cardiac angiography. Kidney Int. 2002; 62 2202-2207
- 15 Elasy T A, Anderson R J. Changing demography of acute renal failure. Sem Dial. 1996; 9 438-443
- 16 Epstein F H, Prasad P. Effects of furosemide on medullary oxygenation in younger and older subjects. Kidney Int. 2000; 57 2080-2083
- 17 Erley C M, Duda S H, Rehfuss D, Scholtes B, Bock J, Muller C, Osswald H, Risler T. Prevention of radiocontrast-media-induced nephropathy in patients with pre-existing renal insufficiency by hydration in combination with the adenosine antagonist theophylline. Nephrol Dial Transplant. 1999; 14 1146-1149
- 18 Erley C M, Duda S H, Schlepkow S, Koehler J, Huppert P E, Strohmaier W L, Bohle A, Risler T, Osswald H. Adenosine antagonist theophylline prevents the reduction of glomerular filtration rate after contrast media application. Kidney Int. 1994; 45 1425-1431
- 19 Espinel C H. The FENa test: Use in the differential diagnosis of acute renal failure. JAMA. 1976; 236 579-581
- 20 Esson M L, Schrier R W. Diagnosis and treatment of acute tubular necrosis. Ann Intern Med. 2002; 137 744-752
- 21 Feest T G, Round A, Hamad S. Incidence of severe acute renal failure in adults: results of a community based study. BMJ. 1993; 306 481-483
- 22 Gupta S, Verfaillie C, Chmielewski D, Kim Y, Rosenberg M E. A role for extrarenal cells in the regeneration following acute renal failure. Kidney Int. 2002; 62 1285-1290
- 23 Heemann U, Kribben A, Schäfers R F, Philipp T h. The role of adhesion molecules in chronic rejection. Great Britain: Kluwer Academic Publishers Late graft loss, edited by Touraine JL et al 1997: 63-67
- 24 Herget-Rosenthal S, Hosford M, Kribben A, Atkinson S J, Sanoval R M, Molitoris B A. Characteristics of EYFP-actin and visualization of actin dynamics during ATP depletion and repletion. Am J Physiol. 2001; 281 C1858-C1870
- 25 Herget-Rosenthal S, Stang A, Kohl D, Schäfer U, Jückel K H, Philipp T h, Kribben A. Acute renal failure after bone marrow transplantation revisited (Abstrakt). J Am Soc Nephrol. 1998; 9 132A
- 26 Huber W, Jeschke B, Kreymann B, Hennig M, Page M, Salmhofer H, Eckel F, Schmidt U, Umgelter A, Schweigart U, Classen M. Haemodialysis for the prevention of contrast-induced nephropathy: outcome of 31 patients with severely impaired renal function, comparison with patients at similar risk and review. Invest Radiol. 2002; 37 471-481
- 27 Kellum J A, Levin N, Bouman C, Lameire N. Developing a consensus classification system for acute renal failure. Curr Opin Crit Care. 2002; 8 509-514
- 28 Koch J -A, Plum J, Grabensee B, Mödder U,. PGE1 Study Group . Prostaglandin E1: a new agent for the prevention of renal dysfunction in high risk patients caused by radiocontrast media?. Nephrol Dial Transplant. 2000; 15 43-49
- 29 Kribben A, Edelstein C L, Schrier R W. Pathophysiology of acute renal failure. J Nephrol. 1999; 12 (Suppl 2) S142-151
- 30 Kribben A, Feldkamp T, Hörbelt M, Lange B, Pietruck F, Herget-Rosenthal S, Heemann U, Philipp T. ATP protects, by way of receptor-mediated mechanisms, against hypoxia-induced injury in renal proximal tubules. J Lab Clin Med. 2003; 14 67-73
- 31 Lassnigg A, Donner E, Grubhofer G, Presterl E, Druml J, Hiesmayr M. Lack of renoprotective effects of dopamine and furosemide during cardiac surgery. J Am Soc Nephrol. 2000; 11 97-104
- 32 Levy E M, Viscoli C M, Horwitz R I. The effect of acute renal failure on mortality. JAMA. 1996; 275 1489-1494
- 33 Liano F, Pascual J,. Madrid Acute Renal Failure Study Group . Epidemiology of acute renal failure: a prospective, multicenter, community-based study. Kidney Int. 1996; 50 811-818
- 34 Mehta R L, Clark W C, Schetz M. Techniques for assessing and achieving fluid balance in acute renal failure. Curr Opin Crit Care. 2002; 8 535-543
- 35 Mehta R L, McDonald B, Gabbai F, Pahl M, Farkas A, Pascual M T, Zhuang S, Kaplan R M, Chertow G M. Nephrology consultation in acute renal failure: does timing matter?. Am J Med. 2002; 113 527-528
- 36 Mehta R L, Pascual M T, Soroko S, Chertow G M. for the PICARD study group . Diuretics, mortality, and nonrecovery of renal function in acute renal failure. JAMA. 2002; 288 2547-2553
- 37 Metcalfe W, Simpson M, Khan I H, Prescott G J, Simpson K, Smith W C, MacLeod A M. Scottish renal registry: Acute renal failure requiring renal replacement therapy: incidence and outcome. QJM. 2002; 95 579-583
- 38 Miller T R, Andersen R J, Linas S L, Henrich W L, Berns A L, Gabow P A, Schrier R W. Urinary diagnostic indices in acute renal failure. Ann Intern Med. 1978; 89 47-50
- 39 Molitoris B A. Transitioning to therapy in ischemic acute renal failure. J Am Soc Nephrol. 2003; 14 265-267
- 40 Mueller C, Buerkle G, Buettner H J, Petersen J, Perruchoud A P, Eriksson U, Marsch S, Roskamm H. Prevention of contrast media-associated nephropathy: randomized comparison of 2 hydration regimens in 1620 patients undergoing coronary angioplasty. Arch Intern Med. 2002; 162 329-336
- 41 Myers B D, Moran S M. Hemodynamically mediated acute renal failure. N Engl J Med. 1986; 314 97-105
- 42 National Kidney and Urologic Diseases Advisory Board 1990 .Long range plan: Window on the 21th century. NIH publication 1990 number 90 - 583: 47-48
- 43 Pietruck F, Blaschke S, Lange B, Geng H, Philipp Th, Kribben A. Hypoxia reversibly inhibits organic cation transport in isolated rat proximal tubules (Abstrakt). J Am Soc Nephrol. 2001; 12 790A
- 44 Ponticelli C, Villa M, Cesana B, Montagnio G, Tarantino A. Risk factors for late kidney allograft failure. Kidney Int. 2002; 62 1848-1854
- 45 Pui C H. Rasburicase: a potent urolytic agent. Expert Opin Pharnacother. 2002; 3 433-452
- 46 Ronco C, Bellomo R. Prevention of acute renal failure in the critical ill. Nephron. 2003; 93 C13-C20
- 47 Schnermann J, Levine D Z. Paracrine Factors in Tubuloglomerular Feedback: Adenosine, ATP, and Nitric Oxide. Annu Rev Physiol. 2002; 10.1146/annurev. physiol.65.050102.085738
- 48 Shyu K G, Cheng J J, Kuan P. Acetylcysteine protects against acute renal damage in patients with abnormal renal function undergoing a coronary procedure. J Am Coll Cardiol. 2002; 40 1383-1388
- 49 Sieberth H G, Bulla M, Grabensee B, Morgera S t, Neumayer H -H, Schurek H J. Akutes Nierenversagen. Rationelle Diagnostik und Therapie in der Inneren Medizin. Leitlinien. Deutsche Gesellschaft für Innere Medizin in Zusammenarbeit mit dem Berufsverband Deutscher Internisten Hrsg.: Classen M, Dierksmann R, Heimpel H, Koch K-M, Meyer J, Müller O-H, Specker Ch, Theiss W Stand September 2002 G9: 1-4
- 50 Smith H W. Principles of renal physiology. New York, Oxford University Press 1956: 79-81
- 51 Sutton T A, Fisher C J, Molitoris B A. Microvascular endothelial injury and dysfunction during ischemic acute renal failure. Kidney Int. 2002; 62 1539-1549
- 52 Tepel M, van der Giet M, Schwarzfeld C, Laufer U, Liermann D, Zidek W. Prevention of radiographic-contrast-agent-induced reductions in renal function by acetylcysteine. N Engl J Med. 2002; 343 180-184
- 53 Thadhani R, Pascual M, Bonventre J V. Acute renal failure. N Engl J Med. 1996; 334 1448-1460
- 54 Trivedi H S, Moore H, Nasr S, Aggarwal K, Agrawal A, Goel P, Hewett J. A randomised prospective trial to assess the role of saline hydration on the development of contrast nephrotoxicity. Nephron. 2003; 93 C29-C34
- 55 Vallero A, Cesano G, Pozzato M, Garbo M, Minelli M, Quadrello F, Formica M. Contrast nephropathy in cardiac procedures: no advantage with prophylactic use of N-acetylcysteine (NAC). G Ital Nefrol. 2002; 19 529-533
- 56 Wagner K, Daul A. Akutes Transplantatversagen nach Nierentransplantation. Deisenhofen: Dustri-Verlag Manuale nephrologicum, Hrsg.: Brass H, Philipp Th, Schulz W 1994 XI-5: 1-8
Priv.-Doz. Dr. med. Andreas Kribben
Klinik für Nieren- und Hochdruckkrankheiten, Universitätsklinikum
Essen
Hufelandstraße 55
45122 Essen
Phone: +49/201/7232552
Fax: +49/201/7235633
Email: andreas.kribben@uni-essen.de