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中华重症医学电子杂志 ›› 2026, Vol. 12 ›› Issue (02) : 129 -133. doi: 10.3877/cma.j.issn.2096-1537.2026.02.006

年度进展

重症肾脏:2025
曾思遥, 李悦, 孙振梓, 王洪亮()   
  1. 150086 哈尔滨,哈尔滨医科大学附属第二医院重症医学科
  • 收稿日期:2026-01-28 出版日期:2026-05-28
  • 通信作者: 王洪亮

Critical care nephrology in 2025

Siyao Zeng, Yue Li, Zhenzi Sun, Hongliang Wang()   

  1. Department of Critical Care Medicine, Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
  • Received:2026-01-28 Published:2026-05-28
  • Corresponding author: Hongliang Wang
引用本文:

曾思遥, 李悦, 孙振梓, 王洪亮. 重症肾脏:2025[J/OL]. 中华重症医学电子杂志, 2026, 12(02): 129-133.

Siyao Zeng, Yue Li, Zhenzi Sun, Hongliang Wang. Critical care nephrology in 2025[J/OL]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2026, 12(02): 129-133.

重症肾脏病学正从急性期支持向涵盖机制靶向、临床精准决策及长期风险防控的综合防治体系演进。2025年的多项研究深化了对急性肾损伤(AKI)发病机制的认识,代谢重编程、铁死亡、表观遗传调控及免疫炎症网络成为核心研究热点,并指向新的干预靶点。临床实践趋于精准化:AKI亚型研究推动分层治疗;连续性肾脏替代治疗(CRRT)的启动时机更强调审慎与个体化决策;液体管理借助人工智能(AI)与血流动力学耦合概念实现精细化;心肾综合征(CRS)的管理强调多器官协同与新型药物的应用。远期随访数据证实,AKI是慢性肾脏病(CKD)进展的重要风险起点,“AKI-to-CKD”连续进程管理理念逐渐成为共识。未来的发展依赖于基础研究的临床转化、多中心随机对照试验的验证以及多学科协作的全程管理模式的建立。本文对相关研究进行系统综述,以期为未来研究方向及临床实践提供参考。

Critical care nephrology is evolving from a discipline focused primarily on acute organ support toward an integrated framework encompassing mechanistic insights, precision-based clinical decision-making, and long-term risk management. Advances reported in 2025 have further expanded the understanding of acute kidney injury (AKI) pathogenesis, with metabolic reprogramming, ferroptosis, epigenetic regulation, and immune-inflammatory networks emerging as major research priorities and potential therapeutic targets. Clinical management is becoming increasingly individualized and precise. AKI subphenotyping is facilitating stratified therapeutic strategies, while decisions regarding the initiation of continuous renal replacement therapy (CRRT) are shifting toward more cautious and patient-specific approaches. Fluid management strategies are being refined through the integration of artificial intelligence and the concept of hemodynamic coupling. In addition, management of cardiorenal syndrome (CRS) increasingly emphasizes multi-organ coordination and the application of novel therapeutic agents. Long-term follow-up studies have confirmed that AKI is a significant risk factor for chronic kidney disease (CKD) progression, leading to broad recognition of the "AKI-to-CKD continuum" as a key concept in patient management. Future progress in critical care nephrology will depend on the translation of mechanistic discoveries into clinical practice, validation through multicenter randomized controlled trials, and the establishment of multidisciplinary, continuum-of-care models. This paper provides a systematic review of related research to offer reference for future research directions and clinical practice.

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