Zusammenfassung
Neue Leitlinien der KDIGO-Arbeitsgruppe vereinheitlichen die Definition des akuten Nierenversagens (ANV) und der akuten Nierenkrankheit und ermöglichen damit die Beurteilung der Prognose und der Wirksamkeit von diagnostischen, prophylaktischen und therapeutischen Maßnahmen in verschiedenen Patientengruppen. Bei dem ANV sind Schweregrad und Dauer entscheidende Faktoren für die Entwicklung einer chronischen Nierenkrankheit und der Mortalität. In der Frühphase des ANV muss der optimale Volumenstatus schnell wieder hergestellt werden, während in der Phase des etablierten ANV eine Volumenüberladung vermieden werden sollte. Neue Biomarker sind für die Früherkennung und Prognose des ANV vielversprechend, können aber noch nicht in der Routine eingesetzt werden. Die Urinmikroskopie, eine der ältesten und kostengünstigsten Untersuchungsmethoden, liefert wertvolle Hinweise zum Verlauf der Erkrankung.
Abstract
New guidelines of the „Kidney Disease: Improving Global Outcome” (KDIGO) working group standardize the definition of acute kidney injury (AKI) and acute kidney disease (AKD) allowing the assessment of prognosis and efficacy of prophylactic and therapeutic measures in different patient cohorts. The degree of severity and the duration of acute kidney injury are critical factors for the development of chronic kidney disease and mortality. The achievement of optimal fluid volumes is a cornerstone in the treatment during the early phase of AKI, while volume overload should be avoided in the late phase of established AKI. Recently employed biomarkers are promising for the early detection and prognosis of AKI, but cannot yet be used as routine tests. Microscopic urinalysis, a very old and cost-effective diagnostic measure, provides valuable informations about the severity and the course of AKI.
Schlüsselwörter
akutes Nierenversagen - akute Nierenkrankheit - Biomarker
Keywords
acute kidney injury - acute kidney disease - biomarker
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Priv.-Doz. Dr. med. Thorsten Feldkamp
Klinik für Nephrologie
Universitätsklinikum
Essen
Universität Duisburg-Essen
Hufelandstr.
55
45122 Essen
Phone: 0201/723-3955
Fax: 0201/723-5318
Email: thorsten.feldkamp@uk-essen.de
