休克是急性肾功能衰竭(ARF)的原因之一。休克时ARF的发生率较高。近年来人们发现,休克可并发多系统器官功能衰竭(MSOF),其中ARF所占比例也高。在第二次世界大战中ARF的病死率高达91%,随着对ARF病理生理认识的提高和透析疗法的开展,病死率有所下降,但仍不够满意。发病原因休克引起ARF的原因有失血后血容量和(或)有效循环量不足、肾血流量(RBF)减少;严重创伤和挤压综合征、烧伤等可导致肾小管阻塞为主的改变;感染所致的休克可使肾脏发生一系列改变;心源性休克可引起供血不足、肾缺血等。病理生理休克导致ARF的机理目前认为是多方面的。由于各家采用的模型不同,因此对ARF的病理生理改变至今仍未有结论。从现有资料来看,可以归纳如下: 一、肾血流动力的改变当休克发生时,交感 Shock is one of the causes of acute renal failure (ARF). The incidence of ARF in shock is high. In recent years, people found that shock can be complicated by multiple system organ failure (MSOF), of which the proportion of ARF is also high. In the Second World War ARF mortality rate as high as 91%, with the understanding of ARF pathophysiology and dialysis therapy carried out, the case fatality rate declined, but still not satisfied. Causes of shock ARF caused by blood loss after and / or the effective circulation volume, renal blood flow (RBF) reduction; severe traumatic and crush syndrome, burns and other can lead to tubular obstruction-based changes; infection Shock caused by the kidneys can make a series of changes; cardiogenic shock can cause lack of blood supply, renal ischemia and so on. The pathophysiology of shock-induced ARF is now thought to be multifaceted. Due to the different models used by different families, the pathophysiological changes of ARF have not been concluded yet. From the available data, can be summarized as follows: First, changes in renal blood flow when shock occurs, sympathetic