摘要药物相关性急性肾损伤(AKI)是临床医学中常见的问题,在儿童更为多发,特别是临床上合并重症感染、低循环血容量、充血性心力衰竭、糖尿病、慢性肾病患儿,更易合并药物相关性AKI.某些药物可通过引发肾小球内血流动力学的改变、氧化应激、过敏反应、肾内阻塞、肾小管细胞炎症改变、间质性肾炎、横纹肌溶解、血栓性微血管病及代谢紊乱等导致AKI的发生.因此,药物不良反应的早期检测对预防其进展至终末期肾病很重要,但目前尚缺乏特异性检测手段.预防措施包括需要了解药物引起肾毒性的机制,同时在治疗开始前评估肾功能,针对不同原发疾病调整药物剂量,避免肾毒性药物组合使用,一旦发生AKI,应及时干预治疗,并纠正危险因素,积极改善预后.

abstractsDrug-related acute kidney injury(AKI)is a common problem in clinical medicine.It is more prone to occur in children,especially in children with severe infection,low circulating blood volume,congestive heart failure,diabetes and chronic kidney disease clinically.Mechanisms include altered intra-glomerular haemodynamics, oxidative damage,hypersensitivity reactions,renal obstruction,tubular inflammatory changes,interstitial nephritis,rhab-domyolysis,thrombotic microvascular disease and metabolic disorders. Therefore,the early detection of adverse drug reactions to prevent its progression to end-stage renal disease is important.Despite many efforts to improve the early assessment of AKI in patients,effective markers are still lacking.Preventive measures requires knowledge of mecha-nisms of drug-induced AKI,improve the prognosis by correcting risk factors,assessing baseline renal function before initiation of therapy,adjusting the drug dosage and avoiding use of nephrotoxic drug combinations.