肝肾综合征诊断标准和分型的演变与进展

肝脏 ›› 2026, Vol. 31 ›› Issue (3): 297-304.

肝肾综合征诊断标准和分型的演变与进展

于乐成, 郝坤艳, 马雨婷, 王雪

南京 210002 南京大学医学院附属金陵医院(东部战区总医院)肝病中心暨感染病科(于乐成,郝坤艳) ;
南京 210002 南京医科大学金陵临床医学院(于乐成,郝坤艳,马雨婷,王雪)

收稿日期:2026-03-16 出版日期:2026-03-31 发布日期:2026-05-19
通讯作者: 于乐成,Email:gslsycy@163.com

Received:2026-03-16 Online:2026-03-31 Published:2026-05-19

摘要/Abstract

摘要： 肝肾综合征(hepatorenal syndrome,HRS)是晚期肝硬化等终末期肝病和门静脉高压症的一种严重并发症,以功能性肾衰竭为主要特征,病死率明显增加。随着对HRS发病机制认识的加深,以及非肝病急性肾损伤(acute kidney injury,AKI)、急性肾病(acute kidney disease,AKD)和慢性肾病(chronic kidney disease,CKD)定义及诊断标准的演进,HRS的诊断标准和分型随之不断演变,共有4个版本。HRS的诊断指标已出现重要变化,传统的HRS-1和HRS-2分型已被弃用,取而代之的是HRS-AKI(包括AKI-1a和AKI-1b)、HRS-AKD和HRS-CKD分型,后两者也被合称为非AKI型HRS(HRS-NAKI)。本文梳理并阐释了不同版本之间的关键异同,以帮助临床医生更好地理解和掌握HRS诊断标准和分型及治疗策略的最新进展。

关键词: 肝肾综合征, 急性肾损伤, 急性肾病, 慢性肾病, 诊断标准, 分型

于乐成, 郝坤艳, 马雨婷, 王雪. 肝肾综合征诊断标准和分型的演变与进展[J]. 肝脏, 2026, 31(3): 297-304.

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