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??acute renal failure ARF???R????????????????????
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1????????????????
1???? 24?400ml??17ml??100ml24h??????????????1 020?2Ommo1L?????ARF??????????1.0101.012?40mmoIL????????????
2???????????????????????????????????????????????????????????????????????
3????????????????NPN?????????????????????????????????????????????
(4)?????????????????????????????????????????
(5) ????????????????????????????????????????????????????????????????
6????????????????????????714?27????????ARF?...
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????
?????????????????????????????????????24???10151025??1???????????1001???1040??10100003?????????????1018?????0008????????????????????????????????????????????????
?SG??????????????????????????????????????????? ?4???????????????1??????????1010???????1003
2????????????????1040?????????????
????????...
?????????????????????????????????????24???10151025??1???????????1001???1040??10100003?????????????1018?????0008????????????????????????????????????????????????
?SG??????????????????????????????????????????? ?4???????????????1??????????1010???????1003
2????????????????1040?????????????
????????...
??????
?????????????(?) ??????
1????
?????????????????????????????????????????????????????1.010~1.020??280mOsm/(kg?H2O)???CRF???????????? ??
2??????
(1)??
???????????????V???????????????????????????????????????????????? ?????
(2)???
???????125(OH)2D3???????????????????????
??????????D-125(OH)2D3?????????...
1????
?????????????????????????????????????????????????????1.010~1.020??280mOsm/(kg?H2O)???CRF???????????? ??
2??????
(1)??
???????????????V???????????????????????????????????????????????? ?????
(2)???
???????125(OH)2D3???????????????????????
??????????D-125(OH)2D3?????????...
??????
?
????
???1.????????6070%???????????renaltubularacidosis????????????????????
2.????Cl-?Na+?1020%???????????????????????????
3.???????????H+K+NH3?Na+????????????????????????????????
?????????
????
???1.????????6070%???????????renaltubularacidosis????????????????????
2.????Cl-?Na+?1020%???????????????????????????
3.???????????H+K+NH3?Na+????????????????????????????????
?????????
????
??????????????????????
??????????????????20:1???40??^
??
????40%~80%????????????????????????????????????????????
???
???????k???? ???????????90%????????????????????????????????????????
???
????????????1/4??200X????B??PH8.0??100
?
90%??????????????????17%~25%??
??
?????????????>0.42mmol...
??????????????????20:1???40??^
??
????40%~80%????????????????????????????????????????????
???
???????k???? ???????????90%????????????????????????????????????????
???
????????????1/4??200X????B??PH8.0??100
?
90%??????????????????17%~25%??
??
?????????????>0.42mmol...
???
???CRF???
?(?)
?(GFR)8050ml/min(?CFR)?{(Scr)133177mol/L??????
?(?)
?(GFR) 5020ml/minScr186446mol/L)???????????????
(?)
GFR 2010ml/minScr451707mol/L????????????????????
(????)
GFR 10ml/minScr707mol/L
????????????????????????...
?(?)
?(GFR)8050ml/min(?CFR)?{(Scr)133177mol/L??????
?(?)
?(GFR) 5020ml/minScr186446mol/L)???????????????
(?)
GFR 2010ml/minScr451707mol/L????????????????????
(????)
GFR 10ml/minScr707mol/L
????????????????????????...