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急性肾功能衰竭(ARF)是指短时问内(几小时或几天),两肾丧失了排泄功能,使血浆尿素氮和肌酐浓度急剧升高,伴水、电解质和酸碱平衡失调。临床表现为少尿或无尿和急骤发生的尿毒症综合征。及时治疗,肾功能可恢复正常。ARF 病程大致分三期:1.初期(病原期)即接触病原后六小时内,肾小管上皮细胞受损伤,但未坏死;2.持续期即病原作用六小时以后,肾小管上皮细胞坏死;3.修复期即大量肾小管上皮细胞开始再生修复、至肾组织结构及功能恢复正常。极轻的损伤可不出现持续期,严重的损伤难以完全修复,而成为慢性肾功能不全。肾中毒和肾缺血均可引起ARF,两者相互作用,难以截然分开(图1)。
Acute renal failure (ARF) refers to a short period of time (a few hours or days), the loss of excretion of both kidneys, the plasma urea nitrogen and creatinine levels rose sharply with water, electrolyte and acid-base balance disorders. Clinical manifestations of oliguria or anuria and sudden uremic syndrome. Timely treatment, renal function can return to normal. ARF course is roughly divided into three phases: 1. The initial (pathogen) that is within six hours after contact with the pathogen, renal tubular epithelial cells damaged, but not necrosis; 2. Duration of the pathogenic effect of six hours later, tubular epithelial cells necrosis; 3. Repair phase that a large number of renal tubular epithelial cells began to regenerate and repair, to the renal tissue structure and function returned to normal. Very light injury may not appear duration, severe damage is difficult to fully repair, and become chronic renal insufficiency. Nephrotoxicity and renal ischemia can cause ARF, the interaction between the two, it is difficult to completely separate (Figure 1).