Behandlung und Progressionsbeeinflussung des akuten Nierenversagens

Das akute Nierenversagen stellt mit ca. 13,3 Mio. Patienten pro Jahr eine der größten Herausforderungen für Gesundheitssysteme weltweit dar [1]. Die häufig multifaktorielle Genese und komplexe pathophysiologische Mechanismen haben bisher die Entwicklung kausaler Therapieoptionen erschwert. Die Beeinflussung der Progression rückt ins Zentrum der Forschungen und es scheint nun auch eine gezielte Behandlung des ANV in greifbare Nähe zu rücken.

Abstract

Acute kidney injury (AKI) represents one of the greatest global health challenges and is associated with high mortality. The often multifactorial etiology and complex pathophysiological mechanisms have so far hampered the development of causal therapeutic options. The treatment should be stage-adapted according to the current KDIGO guideline: avoid nephrotoxicity, optimize volume status and perfusion pressure, monitor serum creatinine, urine output and proteinuria. New insights into the influence of mitochondrial dysfunction and cellular senescence in AKI, well-defined study endpoints, and innovations through nanotechnology may enable targeted drug-based AKI therapy in the future. Especially the weeks following an AKI are a vulnerable phase and crucial for progression management.

Schlüsselwörter

akutes Nierenversagen - medikamentöse Therapie - Progressionsbeeinflussung - Nephrotoxizität - nephrologische Betreuung

Key words

acute kidney injury - drug therapy - progression management - nephrotoxicity - nephrologist follow-up

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