肝细胞衰竭的患者有其特征性的血流动力学改变,即心输出量增多和外周血管阻力下降,并伴随着组织缺氧。血液分流、组织缺氧在急性肝衰的患者表现的尤其突出。正常的肾脏灌注的自我调节机制和代偿机制受到影响,病人也可能发生药物性肾损害,或已经存在与肝脏疾病相关的肾小球疾病或小管疾病,故这些患者易于发展为急性肾功能衰竭(ARF),包括急性肾小管坏死和肝肾综合征,出现肝肾功能衰竭。 1 肾替代疗法的模式演变 Pakela首先运用连续性的肾替代疗法(CRRT)用于治疗 Patients with hepatocellular failure have their characteristic hemodynamic changes, namely increased cardiac output and decreased peripheral vascular resistance, accompanied by tissue hypoxia. Blood diversion, hypoxia in patients with acute liver failure is particularly prominent. Normal renal perfusion self-regulation mechanisms and compensatory mechanisms are affected, the patient may also occur with drug-induced renal damage, or has been associated with liver disease, glomerular disease or tubule disease, so these patients are prone to develop acute renal failure (ARF), including acute tubular necrosis and hepatorenal syndrome, liver and kidney failure. 1 Pattern of Renal Replacement Therapy Pakela first used continuous renal replacement therapy (CRRT) for treatment