Postrenal Akut Böbrek Yetmezliği
Özet
Postrenal akut böbrek yetmezliği (ABY), üriner sistemde oluşan obstruksiyon nedeniyle böbrek fonksiyonlarının aniden bozulmasıyla karakterizedir. Bu obstruksiyon, idrarın böbreklerden mesaneye akışını engelleyerek böbrek içi basıncı artırır, glomerüler filtrasyon hızını düşürür ve böbrek dokusunda hasara neden olur. Postrenal ABY, tüm akut böbrek yetmezliği vakalarının %5 ila %10'unu oluşturur ve daha çok yaşlı bireylerde görülür. En sık nedenleri arasında benign prostat hiperplazisi (BPH), üreter taşları ve pelvik tümörler yer alır. Tanı genellikle ultrasonografi ve diğer kesitsel görüntüleme yöntemleriyle konur. Tedavi, obstruksiyonun giderilmesi ve böbrek fonksiyonlarının korunmasına yönelik müdehalelerdir; kateterizasyon, üreteral stent yerleştirme veya cerrahi müdahaleler gibi yöntemler uygulanabilir. Erken müdahale, böbrek hasarının geri dönüşlü olmasını sağlayabilir. Ayrıca, hastaların uzun dönem izlenmesi, tekrarlayan obstruksiyonların ve komplikasyonların önlenmesi için önemlidir. Postrenal ABY'nin etkin yönetimi, böbrek fonksiyonlarının korunmasını ve hastaların uzun dönem yaşam kalitesinin artırılmasını sağlar. Bu durumun zamanında tanınması ve uygun tedavi yöntemlerinin seçilmesi, hastaların prognozunu önemli ölçüde iyileştirebilir.
Referanslar
Khwaja A. KDIGO clinical practice guidelines for acute kidney injury. Nephron Clinical Practice. 2012;120(4):c179-c84.
Susantitaphong P, Cruz DN, Cerda J, Abulfaraj M, Alqahtani F, Koulouridis I, et al. World incidence of AKI: a meta-analysis. Clinical journal of the American Society of Nephrology. 2013;8(9):1482-93.
Hoste EA, Kellum JA, Selby NM, Zarbock A, Palevsky PM, Bagshaw SM, et al. Global epidemiology and outcomes of acute kidney injury. Nature Reviews Nephrology. 2018;14(10):607-25.
Bairey Merz CN, Dember LM, Ingelfinger JR, Vinson A, Neugarten J, Sandberg KL, et al. Sex and the kidneys: current understanding and research opportunities. Nature Reviews Nephrology. 2019;15(12):776-83.
Cerda J, Lameire N, Eggers P, Pannu N, Uchino S, Wang H, et al. Epidemiology of acute kidney injury. Clinical journal of the American Society of Nephrology. 2008;3(3):881-6.
Hoste EA, Bagshaw SM, Bellomo R, Cely CM, Colman R, Cruz DN, et al. Epidemiology of acute kidney injury in critically ill patients: the multinational AKI-EPI study. Intensive care medicine. 2015;41:1411-23.
Srisawat N, Kulvichit W, Mahamitra N, Hurst C, Praditpornsilpa K, Lumlertgul N, et al. The epidemiology and characteristics of acute kidney injury in the Southeast Asia intensive care unit: a prospective multicentre study. Nephrology Dialysis Transplantation. 2020;35(10):1729-38.
Lameire NH, Bagga A, Cruz D, De Maeseneer J, Endre Z, Kellum JA, et al. Acute kidney injury: an increasing global concern. The Lancet. 2013;382(9887):170-9.
Lameire N, Van Biesen W, Vanholder R. The changing epidemiology of acute renal failure. Nature clinical practice Nephrology. 2006;2(7):364-77.
Joslin J, Wilson H, Zubli D, Gauge N, Kinirons M, Hopper A, et al. Recognition and management of acute kidney injury in hospitalised patients can be partially improved with the use of a care bundle. Clinical Medicine. 2015;15(5):431-6.
Silver SA, Harel Z, McArthur E, Nash DM, Acedillo R, Kitchlu A, et al. Causes of death after a hospitalization with AKI. Journal of the American Society of Nephrology. 2018;29(3):1001-10.
Patschan D, Patschan S, Buschmann I, Ritter O. Loop diuretics in acute kidney injury prevention, therapy, and risk stratification. Kidney and Blood Pressure Research. 2019;44(4):457-64.
UK NCGC. Acute Kidney Injury: Prevention, Detection and Management Up to the Point of Renal Replacement Therapy [Internet]. 2013.
Mulay SR, Anders H-J. Crystal nephropathies: mechanisms of crystal-induced kidney injury. Nature Reviews Nephrology. 2017;13(4):226-40.
Luyckx VA, Tonelli M, Stanifer JW. The global burden of kidney disease and the sustainable development goals. Bulletin of the World Health Organization. 2018;96(6):414.
Al-Jaghbeer M, Dealmeida D, Bilderback A, Ambrosino R, Kellum JA. Clinical decision support for in-hospital AKI. Journal of the American Society of Nephrology. 2018;29(2):654-60.
Busse LW, Ostermann M, editors. Vasopressor therapy and blood pressure management in the setting of acute kidney injury. Seminars in nephrology; 2019: Elsevier.
Prowle JR, Echeverri JE, Ligabo EV, Ronco C, Bellomo R. Fluid balance and acute kidney injury. Nature Reviews Nephrology. 2010;6(2):107-15.
Bhatraju PK, Zelnick LR, Chinchilli VM, Moledina DG, Coca SG, Parikh CR, et al. Association between early recovery of kidney function after acute kidney injury and long-term clinical outcomes. JAMA network open. 2020;3(4):e202682-e.
Weisberg LS, Allgren RL, Genter FC, Kurnik BR. Cause of acute tubular necrosis affects its prognosis. Archives of internal medicine. 1997;157(16):1833-8.
Chertow GM, Burdick E, Honour M, Bonventre JV, Bates DW. Acute kidney injury, mortality, length of stay, and costs in hospitalized patients. Journal of the American Society of Nephrology. 2005;16(11):3365-70.
Morgera S, Kraft AK, Siebert G, Luft FC, Neumayer H-H. Long-term outcomes in acute renal failure patients treated with continuous renal replacement therapies. American Journal of Kidney Diseases. 2002;40(2):275-9.
Prowle JR, Kirwan CJ, Bellomo R. Fluid management for the prevention and attenuation of acute kidney injury. Nature Reviews Nephrology. 2014;10(1):37-47.
Chawla LS, Bellomo R, Bihorac A, Goldstein SL, Siew ED, Bagshaw SM, et al. Acute kidney disease and renal recovery: consensus report of the Acute Disease Quality Initiative (ADQI) 16 Workgroup. Nature Reviews Nephrology. 2017;13(4):241-57.
Kellum JA, Sileanu FE, Bihorac A, Hoste EA, Chawla LS. Recovery after acute kidney injury. American journal of respiratory and critical care medicine. 2017;195(6):784-91.
Oeyen S, De Corte W, Benoit D, Annemans L, Dhondt A, Vanholder R, et al. Long-term quality of life in critically ill patients with acute kidney injury treated with renal replacement therapy: a matched cohort study. Critical Care. 2015;19:1-11.
Referanslar
Khwaja A. KDIGO clinical practice guidelines for acute kidney injury. Nephron Clinical Practice. 2012;120(4):c179-c84.
Susantitaphong P, Cruz DN, Cerda J, Abulfaraj M, Alqahtani F, Koulouridis I, et al. World incidence of AKI: a meta-analysis. Clinical journal of the American Society of Nephrology. 2013;8(9):1482-93.
Hoste EA, Kellum JA, Selby NM, Zarbock A, Palevsky PM, Bagshaw SM, et al. Global epidemiology and outcomes of acute kidney injury. Nature Reviews Nephrology. 2018;14(10):607-25.
Bairey Merz CN, Dember LM, Ingelfinger JR, Vinson A, Neugarten J, Sandberg KL, et al. Sex and the kidneys: current understanding and research opportunities. Nature Reviews Nephrology. 2019;15(12):776-83.
Cerda J, Lameire N, Eggers P, Pannu N, Uchino S, Wang H, et al. Epidemiology of acute kidney injury. Clinical journal of the American Society of Nephrology. 2008;3(3):881-6.
Hoste EA, Bagshaw SM, Bellomo R, Cely CM, Colman R, Cruz DN, et al. Epidemiology of acute kidney injury in critically ill patients: the multinational AKI-EPI study. Intensive care medicine. 2015;41:1411-23.
Srisawat N, Kulvichit W, Mahamitra N, Hurst C, Praditpornsilpa K, Lumlertgul N, et al. The epidemiology and characteristics of acute kidney injury in the Southeast Asia intensive care unit: a prospective multicentre study. Nephrology Dialysis Transplantation. 2020;35(10):1729-38.
Lameire NH, Bagga A, Cruz D, De Maeseneer J, Endre Z, Kellum JA, et al. Acute kidney injury: an increasing global concern. The Lancet. 2013;382(9887):170-9.
Lameire N, Van Biesen W, Vanholder R. The changing epidemiology of acute renal failure. Nature clinical practice Nephrology. 2006;2(7):364-77.
Joslin J, Wilson H, Zubli D, Gauge N, Kinirons M, Hopper A, et al. Recognition and management of acute kidney injury in hospitalised patients can be partially improved with the use of a care bundle. Clinical Medicine. 2015;15(5):431-6.
Silver SA, Harel Z, McArthur E, Nash DM, Acedillo R, Kitchlu A, et al. Causes of death after a hospitalization with AKI. Journal of the American Society of Nephrology. 2018;29(3):1001-10.
Patschan D, Patschan S, Buschmann I, Ritter O. Loop diuretics in acute kidney injury prevention, therapy, and risk stratification. Kidney and Blood Pressure Research. 2019;44(4):457-64.
UK NCGC. Acute Kidney Injury: Prevention, Detection and Management Up to the Point of Renal Replacement Therapy [Internet]. 2013.
Mulay SR, Anders H-J. Crystal nephropathies: mechanisms of crystal-induced kidney injury. Nature Reviews Nephrology. 2017;13(4):226-40.
Luyckx VA, Tonelli M, Stanifer JW. The global burden of kidney disease and the sustainable development goals. Bulletin of the World Health Organization. 2018;96(6):414.
Al-Jaghbeer M, Dealmeida D, Bilderback A, Ambrosino R, Kellum JA. Clinical decision support for in-hospital AKI. Journal of the American Society of Nephrology. 2018;29(2):654-60.
Busse LW, Ostermann M, editors. Vasopressor therapy and blood pressure management in the setting of acute kidney injury. Seminars in nephrology; 2019: Elsevier.
Prowle JR, Echeverri JE, Ligabo EV, Ronco C, Bellomo R. Fluid balance and acute kidney injury. Nature Reviews Nephrology. 2010;6(2):107-15.
Bhatraju PK, Zelnick LR, Chinchilli VM, Moledina DG, Coca SG, Parikh CR, et al. Association between early recovery of kidney function after acute kidney injury and long-term clinical outcomes. JAMA network open. 2020;3(4):e202682-e.
Weisberg LS, Allgren RL, Genter FC, Kurnik BR. Cause of acute tubular necrosis affects its prognosis. Archives of internal medicine. 1997;157(16):1833-8.
Chertow GM, Burdick E, Honour M, Bonventre JV, Bates DW. Acute kidney injury, mortality, length of stay, and costs in hospitalized patients. Journal of the American Society of Nephrology. 2005;16(11):3365-70.
Morgera S, Kraft AK, Siebert G, Luft FC, Neumayer H-H. Long-term outcomes in acute renal failure patients treated with continuous renal replacement therapies. American Journal of Kidney Diseases. 2002;40(2):275-9.
Prowle JR, Kirwan CJ, Bellomo R. Fluid management for the prevention and attenuation of acute kidney injury. Nature Reviews Nephrology. 2014;10(1):37-47.
Chawla LS, Bellomo R, Bihorac A, Goldstein SL, Siew ED, Bagshaw SM, et al. Acute kidney disease and renal recovery: consensus report of the Acute Disease Quality Initiative (ADQI) 16 Workgroup. Nature Reviews Nephrology. 2017;13(4):241-57.
Kellum JA, Sileanu FE, Bihorac A, Hoste EA, Chawla LS. Recovery after acute kidney injury. American journal of respiratory and critical care medicine. 2017;195(6):784-91.
Oeyen S, De Corte W, Benoit D, Annemans L, Dhondt A, Vanholder R, et al. Long-term quality of life in critically ill patients with acute kidney injury treated with renal replacement therapy: a matched cohort study. Critical Care. 2015;19:1-11.
