nidНефрология и диализNephrology and Dialysis1680-44222618-9801Российское диализное обществоnid-1019Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESОстрая почечная недостаточностьAcute renal failureТомилинаН. А.TomilinaN. A.noemail@neicon.ruПодкорытоваО. Л.PodkorytovaO. L.olga.podkorytova@mail.ruНИИ трансплантологии и искусственных органов Росмедтехнологий, Городская клиническая больница № 52, МоскваRussian Federation200919062025111420Copyright © Томилина Н.А., Подкорытова О.Л., 20252025Томилина Н.А., Подкорытова О.Л.Tomilina N.A., Podkorytova O.L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephro.ru/jour/article/view/1019

В обзоре даны современные представления об этиологии, механизмах развития, включая их классификацию, острого почечного повреждения, а также клиническая картина различных его симптомов, разбираются основные метаболические сдвиги, возникающие при ОПН. Обзор снабжен множеством рисунков и таблиц, в том числе алгоритмов дифференциальной диагностики ОПП, представлены списки лекарственных препаратов, наиболее часто вызывающих ОПП.

In this revue a modern view on etiology of Acute Kidney Injury (AKI), mechanisms of its onset, including their classification are presented. Also clinical features of different AKI symptoms, metabolic disorders and their clinical manifestations are described. A number of figures and tables present the algorithms of differential diagnosis of AKI and the list of the most typical nephrotoxic drugs.

острая почечная недостаточностьострое почечное повреждениеэтиологиямеханизм развитияклиническая картинаReferencesBellomo R., Ronco C., Kellum J.A., Mehta R.L., Palevsky P. (the ADQI workgroup). Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI). Crit Care, 2004. Vol. 8. R204-R212.Bellomo R., Ronco C., Kellum J.A., Mehta R.L., Palevsky P. (the ADQI workgroup). Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI). Crit Care, 2004. Vol. 8. R204-R212.Bellomo R. Материалы I объединенного конгресса «Актуальные проблемы экстракорпорального очищения крови, нефрологии и гемафереза» М.: 29-31 мая 2002.Bellomo R. Материалы I объединенного конгресса «Актуальные проблемы экстракорпорального очищения крови, нефрологии и гемафереза» М.: 29-31 мая 2002.Bonventre J.V., Weinberg J.M. Recent Advances in the Pathophysiology of Ischemic Acute Renal Failure. JASN, 2003. Vol. 14. P. 2199-2210.Bonventre J.V., Weinberg J.M. Recent Advances in the Pathophysiology of Ischemic Acute Renal Failure. JASN, 2003. Vol. 14. P. 2199-2210.Brezis M., Rosen S., Hypoxia of the Renal Medulla - Its Implications for Disease. N Engl J Med, 1995. Vol. 332. P. 647-655.Brezis M., Rosen S., Hypoxia of the Renal Medulla - Its Implications for Disease. N Engl J Med, 1995. Vol. 332. P. 647-655.Brodsky S.V., Yamamoto T., Tada T., Kim B., Chen J., Kajiya F., Goligorsky M.S. Endothelial dysfunction in ischemic acute renal failure: rescue by transplanted endothelial cells. Am J Physiol Renal Physiol, 2002. Vol. 282. F1140-F1149.Brodsky S.V., Yamamoto T., Tada T., Kim B., Chen J., Kajiya F., Goligorsky M.S. Endothelial dysfunction in ischemic acute renal failure: rescue by transplanted endothelial cells. Am J Physiol Renal Physiol, 2002. Vol. 282. F1140-F1149.Clermont G., Acker C.G., Angus D.C., Sirio C.A., Pinsky M.R., Johnson J.P. Renal failure in the ICU: comparison of the impact of acute renal failure and end-stage renal disease on ICU outcomes. Kidney Int, 2002. Vol. 62, P. 986-996.Clermont G., Acker C.G., Angus D.C., Sirio C.A., Pinsky M.R., Johnson J.P. Renal failure in the ICU: comparison of the impact of acute renal failure and end-stage renal disease on ICU outcomes. Kidney Int, 2002. Vol. 62, P. 986-996.Conger J.D., Weil J.V. Abnormal vascular function following ischemia-reperfusion injury. J Investig Med, 1995. Vol. 43: P. 431-442.Conger J.D., Weil J.V. Abnormal vascular function following ischemia-reperfusion injury. J Investig Med, 1995. Vol. 43: P. 431-442.Conger J.D., Robinette J.B., Guggenheim S.J. Effect of acetylcholine on the early phase of reversible norepinephrine-induced acute renal failure. Kidney Int, 1981. Vol. 19. P. 399-409.Conger J.D., Robinette J.B., Guggenheim S.J. Effect of acetylcholine on the early phase of reversible norepinephrine-induced acute renal failure. Kidney Int, 1981. Vol. 19. P. 399-409.Conger J.D. Vascular Alteration on ARF: Roles in initiation and maintenance In: Acute Renal Failure. A Companion to Brenner & Rector’s The Kidney. Ed. by B.A. Molitoris, W.F. Finn. Philadelphia: Saunders, 2001. P. 535.Conger J.D. Vascular Alteration on ARF: Roles in initiation and maintenance In: Acute Renal Failure. A Companion to Brenner & Rector’s The Kidney. Ed. by B.A. Molitoris, W.F. Finn. Philadelphia: Saunders, 2001. P. 535.Gohonson R.J., Feehally J. Comprehensive Clinical Nephrology; Mosby - Edinburgh: 2003. P. 200-201.Gohonson R.J., Feehally J. Comprehensive Clinical Nephrology; Mosby - Edinburgh: 2003. P. 200-201.Goligorsky M.S., Lieberthal W. Pathophysiology of ischemic acute renal failure. In: Atlas of Diseases of the Kidney, ed. by R.W. Schreier. 1999.Goligorsky M.S., Lieberthal W. Pathophysiology of ischemic acute renal failure. In: Atlas of Diseases of the Kidney, ed. by R.W. Schreier. 1999.Goligorsky M.S. Endothelial cell dysfunction and nitric oxide synthase. Kidney Int 2000. Vol. 58. P. 1360-1376.Goligorsky M.S. Endothelial cell dysfunction and nitric oxide synthase. Kidney Int 2000. Vol. 58. P. 1360-1376.Goss C.H., Brower R.G., Hudson L.D., Rubenfeld G.D. Incidence of acute lung injury in the United States. ARDS Network. Crit Care Med 2003; Vol. 31. P. 1607-1611.Goss C.H., Brower R.G., Hudson L.D., Rubenfeld G.D. Incidence of acute lung injury in the United States. ARDS Network. Crit Care Med 2003; Vol. 31. P. 1607-1611.Intensive Care in Nephrology, (Eds. P.T. Murray, H.R. Brady, J.B. Hall), Taylor & Francis, 2007.Intensive Care in Nephrology, (Eds. P.T. Murray, H.R. Brady, J.B. Hall), Taylor & Francis, 2007.Hack C.E., Zeerleder S. The endothelium in sepsis: Sours of and a target for inflammation Crit Care Med, 2001. Vol. 29 (Suppl). P. S21-S27.Hack C.E., Zeerleder S. The endothelium in sepsis: Sours of and a target for inflammation Crit Care Med, 2001. Vol. 29 (Suppl). P. S21-S27.Ho K.M., Sheridan D.J. Furosemid BMJ Doesn’t Prevent Acute Renal Failure, 2006. Vol. 33. P. 406-407.Ho K.M., Sheridan D.J. Furosemid BMJ Doesn’t Prevent Acute Renal Failure, 2006. Vol. 33. P. 406-407.Hoste E.A., Lameire N.H., Vanholder R.C. et al. Acute renal failure in patients with sepsis in a surgical ICU: predictive factors, incidence, comorbidity, and outcome. J Am Soc Nephrol, 2003 Apr. Vol. 14. P. 1022-1030.Hoste E.A., Lameire N.H., Vanholder R.C. et al. Acute renal failure in patients with sepsis in a surgical ICU: predictive factors, incidence, comorbidity, and outcome. J Am Soc Nephrol, 2003 Apr. Vol. 14. P. 1022-1030.Kwon O., Phillips C.L., Molitoris B.A. Ischemia induces alterations in actin filaments in renal vascular smooth muscle cells. Am J Physiology Renal Physiology, 2002. Vol. 282: F1012-F1019.Kwon O., Phillips C.L., Molitoris B.A. Ischemia induces alterations in actin filaments in renal vascular smooth muscle cells. Am J Physiology Renal Physiology, 2002. Vol. 282: F1012-F1019.Liaño F., Pascual J. Epidemiology of acute renal failure: a prospective, multicenter, community-based study. Madrid Acute Renal Failure Study Group. Kidney Int, 1996. Vol. 50. P. 811-818.Liaño F., Pascual J. Epidemiology of acute renal failure: a prospective, multicenter, community-based study. Madrid Acute Renal Failure Study Group. Kidney Int, 1996. Vol. 50. P. 811-818.Mehta R.L., Pascual M.T., Soroko S. et al. Program to Improve Care in Acute Renal Disease (PICARD). Spectrum of acute renal failure in the intensive care unit: The PICARD experience, Kidney Int, 2004. Vol. 66. P. 1613-1621.Mehta R.L., Pascual M.T., Soroko S. et al. Program to Improve Care in Acute Renal Disease (PICARD). Spectrum of acute renal failure in the intensive care unit: The PICARD experience, Kidney Int, 2004. Vol. 66. P. 1613-1621.Molitoris B., Bacallao R. Pathophysiology of Ischemic Acute Renal Failure: Cytoskeletal aspects In Atlas of Diseases of the Kidney. Ed by R.W. Schreier, 1999.Molitoris B., Bacallao R. Pathophysiology of Ischemic Acute Renal Failure: Cytoskeletal aspects In Atlas of Diseases of the Kidney. Ed by R.W. Schreier, 1999.Molitoris B. Transitioning to therapy in ischemic acute renal failure. J Am Soc Nephrol, 2003. Vol. 14. P. 265-267.Molitoris B. Transitioning to therapy in ischemic acute renal failure. J Am Soc Nephrol, 2003. Vol. 14. P. 265-267.Nishida M., Ieshima M., Konishi F. et al. Role of endothelin B receptor in the pathogenesis of ischemic acute renal failure. J Cardiovasc Pharmacol, 2002. Vol. 40. P. 586-593.Nishida M., Ieshima M., Konishi F. et al. Role of endothelin B receptor in the pathogenesis of ischemic acute renal failure. J Cardiovasc Pharmacol, 2002. Vol. 40. P. 586-593.Ronco C., Bellomo R. The Renal effects of noradrenaline and dopamine. Contrib Nephrol. 2001. Vol. 132. P. 146-57.Ronco C., Bellomo R. The Renal effects of noradrenaline and dopamine. Contrib Nephrol. 2001. Vol. 132. P. 146-57.Rosen S., Heyman S. Difficulties in understanding human “acute tubulonecrosis”: Limited data and flawed animal models. Kidney Int, 2001. Vol. 60. P. 1220-1224.Rosen S., Heyman S. Difficulties in understanding human “acute tubulonecrosis”: Limited data and flawed animal models. Kidney Int, 2001. Vol. 60. P. 1220-1224.Schrier R.W. Renal and electrolyte disorders. 2003. P. 437-443.Schrier R.W. Renal and electrolyte disorders. 2003. P. 437-443.Snyder S., Pendergraph B. Detection and evaluation of chronic kidney disease. Am. Fam. Physician. 2005. V. 72. P. 1723-1732.Snyder S., Pendergraph B. Detection and evaluation of chronic kidney disease. Am. Fam. Physician. 2005. V. 72. P. 1723-1732.Sutton T.A., Fisher C.J., Molitoris B.A. Microvascular endothelial injury and dysfunction during ischemic acute renal failure. Kidney Int, 2002. 62. P. 1539-1549.Sutton T.A., Fisher C.J., Molitoris B.A. Microvascular endothelial injury and dysfunction during ischemic acute renal failure. Kidney Int, 2002. 62. P. 1539-1549.Thadhani R., Pascual M., Bonventre J.V. Medical progress - Acute renal failure. N Engl J Med, 1996. Vol. 334. P. 1448-1460.Thadhani R., Pascual M., Bonventre J.V. Medical progress - Acute renal failure. N Engl J Med, 1996. Vol. 334. P. 1448-1460.Uchino S., Kellum J.A., Bellomo R. et al. Acute renal failure in critically ill patients: A multinational multicenter study. JAMA, 2005. Vol. 294. P. 813-818.Uchino S., Kellum J.A., Bellomo R. et al. Acute renal failure in critically ill patients: A multinational multicenter study. JAMA, 2005. Vol. 294. P. 813-818.Waika S.S., Curhan G.C., Wald R, McCarthy E.P., Chertow G.M. Declining mortality in patients with ARF, 1988 to 2002. J Am Soc Nephrol, 2006. Vol. 17. P. 1143-1150.Waika S.S., Curhan G.C., Wald R, McCarthy E.P., Chertow G.M. Declining mortality in patients with ARF, 1988 to 2002. J Am Soc Nephrol, 2006. Vol. 17. P. 1143-1150.

The authors declare that there are no conflicts of interest present.