今年3月14日的第八个“世界肾脏日”，把关注焦点对准了“急性肾脏损伤”。日前，我国著名的肾脏病专家、南方医科大学南方医院肾内科主任侯凡凡院士在肾病日宣教活动上指出，急性肾损伤是一种常见的临床危重症，其发病率和死亡率在我国居高不下，因此应受到重视。她特别提醒，造成国人急性肾损伤的一个常见原因是滥吃药，包括西药、中草药、中成药等，肾脏对药物特别敏感，需要注意。

On 14 March eighth this year"World kidney day",To focus on"Acute kidney injury".recently,China's famous expert in kidney disease/Member of nanfang hospital, southern medical university, director of urology department et al pointed out on nephropathy, propaganda and education activities,Acute kidney injury is a common clinical critical disease,The high morbidity and mortality in China,So should be taken seriously.Her special remind,Cause people a common cause of acute kidney injury is bad medicine,Including western medicine/Chinese herbal medicine/Proprietary Chinese medicine, etc.,Kidney particularly sensitive to drugs,Need to pay attention to.

　　

部分患者可发展成慢性肾病 Some patients may develop into chronic kidney disease

　　急性肾损伤也叫急性肾衰竭，其危害到底有多大？侯凡凡院士介绍，一旦发生，死亡率可高达45%以上，重大疾病、生孩子分娩时大出血、车祸等，都有可能造成急性肾损伤，是很多危重病的并发症，同时也增加危重病死亡率、致残率。这属于急性肾损伤的急性高危因素，省人民医院肾内科主任史伟还介绍急性肾损伤的慢性高危因素，首先是年龄超过65岁的老年人、以前有肾血管性疾病(肾动脉粥样硬化、肾动脉狭窄等)，以及已经存在慢性肾功能不全者、糖尿病患者，还有高血压、心力衰竭和肝功能不全者，正在服用二甲双胍药物等。急性肾损伤的临床表现有尿量减少，全身水肿、脑水肿、厌食恶心呕吐、多尿等。

Acute kidney injury is also called acute kidney failure,How much the harm?Member of et al,In the event of,Mortality can be as high as 45% above,Major diseases/Children of massive hemorrhage during childbirth/Car accident, etc.,Are likely to cause acute kidney injury,Is a lot of critical care complications,At the same time also increases critical patients mortality/morbidity.This belongs to the acute risk factors of acute kidney injury,Provincial people's hospital urology department director Shi Wei also introduces high risk factors of acute kidney injury in chronic,First is the elderly aged over 65/There used to be renovascular disease(Renal sclerosis of arterial congee appearance/Renal artery stenosis, etc),And there have been a chronic renal insufficiency/People with diabetes,There is high blood pressure/Heart failure and hepatic insufficiency,Taking metformin, drugs, etc.The clinical manifestations of acute kidney injury has reduced the volume of urine,anasarca/Brain edema/Anorexia nausea and vomiting/More urine, etc..

　　侯凡凡院士和史伟谈到，一旦患上急性肾损伤，有的是可逆转的，有的则不可逆转，进而发展成慢性肾脏病。“急性肾损伤患者中约有25%-30%属于不可逆转。”省人民医院肾内科主任医师梁馨苓补充说。

Member of et al and Shi Wei said,Once suffering from acute kidney injury,Have a plenty of reversible,Some are irreversible,And then develop into chronic kidney disease."About 25% - 30% in patients with acute kidney injury belongs to the irreversible."Provincial people's hospital urology department director of the physician Liang Xinling added.

　　现在发现，部分急性肾损伤会发展成慢性肾病，年轻人5%-6%会发展成慢性肾病，老人发展成慢性肾病的比例可达16%。慢性肾病的发展会变成尿毒症，需要透析治疗或换肾。因此，必须重视急性肾损伤。急性肾损伤恢复时间越长、越慢，越容易变成慢性肾病。

Now find,Part of acute kidney injury will develop into chronic kidney disease,Young people can develop into chronic kidney disease by between 5% and 6%,Old man develop into chronic kidney disease (CKD) ratio can reach 16%.The development of chronic kidney disease becomes uremia,Need dialysis or kidney transplant.so,Acute kidney injury must not be overlooked.The longer the acute kidney injury recovery time/The slower,The more easily become chronic kidney disease.

　　

含马兜铃酸中药肾毒作用强 Chinese medicine containing aristolochic acid kidney strong poison effect

　　侯凡凡还谈到，急性肾损伤的常见原因之一是滥吃药，包括西药、中草药、中成药的药物引起的急性肾损伤，这样的情况在我国发生率很高，人对吃药太随意，把吃药当保健，不在医生指导下服药。

Et al also talked about,A common cause of acute kidney injury is one of the medicine,Including western medicine/Chinese herbal medicine/Proprietary Chinese medicine of drug-induced acute kidney injury,The situation with a high incidence in our country,Take medicine too casual,To take medicine when health care,Not taking medication under the guidance of doctors.

　　乱吃中药引起的急性肾损伤完全是人为造成，完全可以避免悲剧发生。史伟在此介绍临床遇到两个病例：一位是刚毕业的女大学生，因为牙痛找中医开了一剂草药方子，连续吃了一周，突然感觉身体异常，排尿减少，来医院检查，结果已是尿毒症，且不可逆转。原来治牙痛的草药方中有一味药是朱砂莲，含有马兜铃酸。还有一个女孩，为治脸上的青春痘，吃了一种叫龙胆泻肝丸的药，造成急性肾损伤。

Eating Chinese medicine cause of acute kidney injury is entirely man-made,Can completely avoid the tragedy.Shi Wei here met two clinical cases:One is the female college students graduating from university,Because of toothache find opened a dose of herbal prescription in TCM,Continuous eating for a week,Suddenly feel abnormal body,Micturition reduce,To a hospital checking,The result is uremia,And irreversible.Original cure toothache herb prescription medicine is cinnabar of lotus,Containing aristolochic acid.There is a girl,To treat acne on her face,Eat a medicine called gentian have diarrhoea liver pills,Acute kidney injury.

　　史伟特别强调，广东人对中医药情有独钟，认为中药温和毒副作用小，然而实际上像含有马兜铃酸成分的一类中药有较强的肾毒性，短时间大量服用可造成服用者急性肾损伤。早在多年前，肾脏科医师就已经明确，部分中草药中含有一种“马兜铃酸”的物质会引发肾损伤，临床称之为“马兜铃酸肾病”，马兜铃酸肾病没有有效的治疗方法，临床上不应用含马兜铃酸的中草药，欧美等国已全面禁止使用该类药物的使用。

Shi Wei with particular emphasis on,Guangdong traditional Chinese medicine has a special liking,Think Chinese medicine mild side effects is small,However as containing aristolochic acid ingredients of traditional Chinese medicine has strong renal toxicity,Short time a large number of users can be caused by acute kidney injury.As early as several years ago,Nephrologists have been clear,One part is contained in Chinese herbal medicine"Aristolochic acid"Substances that can cause kidney damage,Clinical call"Aristolochic acid nephropathy",Aristolochic acid nephropathy no effective treatments,The clinical application of Chinese herbs containing aristolochic acid,Europe and the United States and other countries have banned the use of using these drugs.

　　

乱吃抗生素可致肾损伤 Antibiotics can cause kidney damage

　　小方竟因为感冒吃药而吃出了大祸！本以为感冒是小事，但吃了感冒药未有改善，小方又吃了好几种感冒药，为了疗效好，他干脆三四种感冒药一起吃。生病期间，他因为胃口差，几乎没吃东西。才几天，他就感觉到眼肿、尿少，接着全身水肿，便马上就医。一查便发现他肌酐很高，是发生了急性肾损伤。南方医院肾内科副主任王国保教授称，小方吃的看起来不同的几种感冒药，其实是一类药，再加上他几乎没进食进水，大剂量的药在血内，损伤了肾。

Small fang unexpectedly because of a cold to take medicine and eat out of the disaster!Thought cold is a little things,But eat the cold medicine did improve,Small party again eat several kinds of medicine,In order to good curative effect,He just three or four cold medicine eat together.During the illness,Because of his poor appetite,Almost didn't eat.Only a few days,He will feel the eye is swollen/Less urine,Then the whole body edema,Then go to a doctor right away.Check and found that his creatinine is very high,Is acute kidney injury happened.Nanfang hospital urology department, deputy director of professor Wang Guobao said,Small party looks different to eat some cold medicine,It is a kind of medicine,Plus he almost didn't eat into the water,Larger doses of the drug in the blood,Damage to the kidney.

　　西药造成的急性肾损伤，主要包括抗生素、造影剂、退烧药等，如青霉素、磺胺类、克林霉素、非甾体抗炎药等，均有导致肾脏急性损伤的可能，一是因为个体对该药过敏，另一个是药物对肾脏的直接毒性。王国保说，药物过敏与个人体质有关，有的人对一类药过敏；有的人是对药物的添加剂、杂质过敏。梁馨苓表示，从临床病例看，药物过敏的人日常看不出有何特别，所以比较难防备，但这个群体非常少见。

Western medicine cause of acute kidney injury,Mainly including antibiotics/Contrast agents/Fever, etc.,Such as penicillin/sulfa/clindamycin/Non-steroidal anti-inflammatory drugs (nsaids), etc,Have may lead to acute kidney injury,Because individuals allergic to the drug,Another is the drug directly toxic to the kidneys.Wang Guobao said,Drug allergy is related to personal physical fitness,There are some people who are allergic for a class of drugs;Some people is to drug additives/Allergic impurities.Liang Xinling said,Look from the clinical cases,Drug allergies are everyday can't see what's so special about,So hard to guard against,But this group is very rare.

　　

-相关报道 - the reports

　　

增强CT检查易出现急性肾衰 Enhanced CT examination is easy to appear the acute renal failure

　　60多岁的李大爷去年到医院做了一次体检，在做了增强CT检查之后，回到家很快出现无尿，这可把李大爷急坏了，家人知道后立马陪他去医院做检查，检查后居然发现，李大爷的肾小球滤过率只有正常人的三分之一，血肌酐明显升高，肾脏功能已经严重损害。医生诊断李大爷患了急性肾功能衰竭，而造成肾衰竭的原因就是增强CT检查中造影剂的使用，这种病例在临床上称为造影剂肾病。

Last year, more than 60 - year - old Mr. Lee to go to the hospital for a medical check-up,After do enhanced CT examination,Back home soon appeared no urine,This can put the big ye li urgent is broken,After the family know immediately to accompany him to the hospital to do check,Was found after inspection,Li big ye of glomerular filtration rate is only one-third of normal people,Elevated serum creatinine obviously,Kidney function had been severely damaged.The doctor diagnosed the big ye li suffered from acute renal failure,And the cause of renal failure is to enhance the use of contrast media in CT examination,This kind of cases clinically known as contrast nephropathy.

　　史伟谈到，增强CT检查在临床运用越来越广泛，在检查过程中造成的急性肾病问题也越来越突出。通常正规大医院，在做增强检查前，都会充分了解患者身体情况，进行评估。对于高危患者，如必须要做增强检查，医院会提前对患者进行水化治疗，以减少急性肾损伤的发生。虽然水化治疗不能完全100%避免急性肾损伤，但该手段是公认的重要预防措施，梁馨苓补充说。

Shi Wei talked about,Enhanced CT examination is becoming more and more widely in clinical use,In acute kidney disease caused by the problems in the process of inspection is also more and more prominent.Usually regular hospitals,Before do enhancement examination,Will fully understand the patients physical condition,To assess the.In high-risk patients,Such as have to do to enhance inspection,Hospital would be early hydration therapy on the patients,In order to reduce the occurrence of acute kidney injury.Although can't completely avoid 100% hydration treatment of acute kidney injury,But the method is recognized as one of the important preventive measures,Liang Xinling added.

　　据介绍，造影剂肾病就是在使用造影剂后，短时间产生的急性肾功能衰竭。普通CT是指不用造影增强或造影的普通扫描。增强CT是指经静脉注入水溶性碘造影剂再行扫描，可让病变显影更为清楚。

According to introducing,Contrast nephropathy is after the use of contrast agents,A short period of time of acute renal failure.Ordinary CT refers to ordinary scan without contrast enhancement or imaging.Enhanced CT is refers to the scanning by intravenous injection of water-soluble iodine contrast agent,Can let a lesion enhancement is more clear.

　　

-健康提醒 - health reminder

　　

简单尿检便知肾脏基本状况 A simple urine test to know kidney basic situation

　　肾脏一旦发生严重急性损伤，会出现尿量减少、颜面或下肢浮肿、面色苍白、血压升高、头晕头痛、胸闷心慌、恶心呕吐、刷牙出血、便血、女性月经过多等。不过要明确诊断，还有赖于血液、尿液和影像学检查等，一旦出现不适症状，应及时进行相关检查。

In the event of severe acute renal injury,Will be reduced the volume of urine/Face or lower limb swelling/pale/High blood pressure/Dizziness, headache/Chest tightness flustered/Nausea and vomiting/Brush your teeth bleeding/bloody/Many female menstruation, etc.But need to have a clear diagnosis,Also depends on the blood/Urine and imaging examination, etc,Once the symptoms appeared,Shall promptly carry out the inspection.

　　史伟和梁馨苓都建议，普通人每年一次的常规体检最好增加“尿常规”一项，简便又有效，这是评估肾脏功能的基本指标，大部分肾病问题都可通过此反映出来，还有尿检要用“晨尿“。

Shi Wei and Liang Xinling are suggested,Ordinary people a regular medical check-up best increase every year"Routine urine"a,Simple and effective,This is the basic indicators to assess kidney function,Most of the kidney disease can be reflected by this problem,Have a urine test to use"The morning urine".

　　

●常见含马兜铃酸的中草药 Low common Chinese herbs containing aristolochic acid

　　关木通、广防已、青木香、淮木通、朱砂莲、细辛、通城虎、寻骨风、假大薯、逼血雷、管南香、青木香、马兜铃果、天仙藤(茎叶)、青木香(根)、南木香(白防己)

Close also/Fangchi root/Radix aristolochiae/Huai akebia stem/Vermilion lotus/asarum/Tiger city/Bones wind/False large fries/Forced blood ray/Tube south sweet/Radix aristolochiae/Aristolochic fruit/Fairy cane(Cauline leaf)/Radix aristolochiae(The root)/The south is sweet(White out the)

　　

●常见含马兜铃酸的中成药和方剂 Low common proprietary Chinese medicine and the prescriptions containing aristolochic acid

　　龙胆泻肝丸、排石冲剂(排石汤)、分清止淋丸、妇科分清丸、甘露消毒丹、复方珍珠暗疮片、耳聋丸、当归四逆汤、玄珠狼疮丸、冠心苏合丸、跌打丸、独活寄生汤。

Gentian purging liver pills/Row of stone granule(Row of stone soup)/Distinguish between check drench pill/Gynecology distinguish pills/Dew disinfection Dan/Compound pearl acne/Deafness pill/Angelica four inverse soup/XuanZhu lupus pill/Bolted together pill/paishi/Live with parasitic soup.

　　急性肾损伤早期症状隐匿，即使尿量开始减少，也容易被忽视。典型急性肾脏损伤会出现从少尿到多尿的症状，直至肾功能完全恢复，少数患者肾功能不能完全恢复，遗留永久性肾损害。对于少尿和多尿期饮食生活的调整，专家给予了以下建议：

Early symptoms of acute kidney injury,Even began to decrease of urine,Also easy to be ignored.Acute kidney injury will be less urine to typical symptoms of polyuria,Until fully recovered renal function,A few patients can't fully recover renal function,The legacy of permanent kidney damage.For urine oliguria and phase of the diet life adjustment,Experts offer the following Suggestions:

　　少尿期：首先要卧床休息，保持环境安静，以降低新城代谢，减轻肾脏负担。尽量利用胃肠道补充营养，可进食清淡、低盐、低脂、低磷、高钙、优质低蛋白饮食，如牛奶、鱼。少吃动物内脏和易过敏的食物等，并酌情限制水分、钠盐和含钾食物摄入。

Oliguria stage:First of all want to stay in bed,Keep quiet environment,In order to reduce metabolism,Reduce the financial burden on the kidney.As far as possible use of gastrointestinal nutrition,Can eat light/Low salt/Low fat/Low phosphorus/High calcium/High quality low protein diet,Such as milk/The fish.Eat less animal innards and allergy food, etc,And limit moisture content/Sodium and potassium intake.

　　多尿期：可逐渐增加活动量，以不感到疲劳为宜；准确记录24小时尿液出入量，补充适量液体，保持液体出入平衡；监测生化指标动态变化，及时发现谁电解质紊乱；同时给予高糖、高维生素、高热卡食物；尿量大于3000ml/d，可多吃含钾食物，如桔子、榨菜等；此外注意增加机体抵抗力，预防感染。

Urine period:To gradually increase activity,It is advisable to not to fatigue);Accurately record 24 hours urine volume,Add a moderate amount of liquid,Keep the liquid in and out of balance;Dynamic change monitoring biochemical indicators,Timely find out who electrolyte disorder;At the same time give high sugar/High vitamin/High in calories;Urine output is greater than 3000 ml/d,Can eat more foods containing potassium,Such as orange/Pickle, etc;Also note that increase the body resistance,To prevent infection.