Post Date December, 03 2023
In fact, it should be said that if acute renal injury cannot be detected and treated in a timely manner, it can often destroy the normal working ability of the kidney in a short period of time, and also produce a domino-like interaction that affects other important internal organs in the body, ultimately leading to serious complications such as dysfunction of various organs such as the heart, liver, and lungs, It is called multiple organ dysfunction syndrome in medicine. Multiple organ dysfunction syndrome (MODS) is one of the diseases with the highest mortality rate in clinical practice and poses great harm.
Therefore, once the risk factors of acute renal injury occur, they should be corrected and controlled as soon as possible, and efforts should be made to avoid and reduce the chances of acute renal injury and multiple organ dysfunction that may bring great difficulties to the treatment of the disease.
What risk factors contribute to acute renal injury:
In fact, these factors are everywhere accompanying us, "lurking" day and night and waiting for the opportunity to disrupt. Generally, the elderly and infants, patients after surgery (especially those undergoing cardiac surgery or major surgery), patients with diabetes, patients with long-term poor control of hypertension, patients with chronic cardiac insufficiency, and patients with chronic kidney disease are all high-risk groups.
? aged
Due to the natural aging of the body, it is often accompanied by various chronic diseases, renal function degradation, and a decline in the ability to detoxify drugs;
Due to aging, renal blood flow gradually decreases, and creatinine clearance decreases by approximately 10% every 10 years. Decreased renal function makes elderly people more sensitive to ischemia and toxin damage;
In the elderly, muscle tissue decreases and muscle catabolism also decreases, resulting in a lack of correlation between serum creatinine levels and creatinine clearance. At this time, medication based on serum creatinine levels is very likely to lead to overdose and nephrotoxicity;
Impairment of self regulatory mechanisms and decreased secretion of vasoactive substances have accelerated the occurrence and progression of acute renal injury in the elderly.
? baby
Due to the weak immunity of infants and young children, their vulnerability to illness, their high sensitivity to nephrotoxic drugs, their poor tolerance, and the narrow safety range of drug use, it is important to avoid or minimize the use of drugs with nephrotoxicity. If it cannot be avoided and must be used, it is necessary to adjust the dosage, reduce the dosage, and pay attention to protecting and monitoring renal function.
? Patients with chronic kidney disease
"Due to impaired renal self-regulation, these patients can easily shift from chronic to acute renal injury when combined with factors that exacerbate renal injury, such as infection, urinary tract obstruction, water electrolyte disturbances, and the use of nephrotoxic drugs.".
In addition to age factors, kidney damage often occurs when the body is exposed to certain acute or severe diseases. In ICUs (Intensive Care Units) that treat critically ill patients, acute renal injury is one of the most common factors threatening patients' lives, with a probability of occurrence of over 30%.
For example, a large amount of blood loss caused by various reasons (such as trauma, blood loss during surgery, etc.), and a large amount of fluid loss caused by various reasons and pathways (such as vomiting, diarrhea, gastrointestinal dehydration, polyuria, renal dehydration, skin dehydration, etc.) can cause insufficient blood volume. At this point, the flow of blood to the kidneys decreases, leading to renal ischemia, which can easily lead to acute renal injury.
For example:
After undergoing cardiac surgery or other major surgical procedures;
Cardiovascular diseases such as cardiogenic shock, cardiac insufficiency, and hypotension;
Severe infection and sepsis;
Severe trauma, such as burns, crush injuries, severe fractures, etc;
Severe obstetric complications such as pregnancy induced hypertension syndrome and eclampsia.
In daily life, taking medicine when ill is a common occurrence, but the scourge of "taking medicine indiscriminately when ill" is profound. "It is not uncommon for patients to experience acute renal injury due to headache, fever, and disorderly administration of cold medicines and pain relievers.". Little wonder, whether traditional Chinese medicine or Western medicine, most drugs need to be excreted through the kidney. "It is a drug with three levels of toxicity, most of which is caused by kidney damage. Excessive or long-term use can become the most common risk factor for acute kidney damage around us.".
The most common types of drugs that cause kidney damage include:
Antibiotics: Aminoglycoside antibiotics (gentamicin, amikacin, etimicin, isopamycin sulfate, etc.) and vancomycin have strong renal toxicity. Cephalosporins are also common drugs that induce renal injury;
Diuretics;
Ionic iodine containing contrast agents used in imaging examinations, such as meglumine diatrizoate;
Surgical anesthetics;
Traditional Chinese medicine, such as weight loss medicine, Mutong in Paishi Granule, Magnolia officinalis, Fangji, Xanthium sibiricum, cinnabar, etc.
Anti malignant tumor drugs;
Antipyretic and analgesic drugs.
These drugs are particularly dangerous when used in patients with dehydration, diabetes, cirrhosis, chronic kidney disease, the elderly and young children, and are prone to induce acute kidney injury. Before choosing drugs, renal function must be fully evaluated and regularly monitored, and substitutes with similar efficacy and low renal toxicity should be selected as far as possible.
