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A exacerbação aguda da Doença Renal Crônica (DRC), conhecida como \u201cdoença renal aguda sobre crônica\u201d (ACKD), é caracterizada por uma piora súbita da função renal em pacientes com DRC preexistente, frequentemente desencadeada por infecções, desidratação, medicamentos nefrotóxicos ou obstrução urinária. Este estudo, por meio de uma revisão integrativa, analisou evidências publicadas entre 2015 e 2023, com o objetivo de identificar estratégias de manejo eficazes para esses episódios. Os resultados mostram que ACKD é subnotificada e associada a fatores de risco como diabetes, doenças cardiovasculares e baixa albumina sérica. Complicações incluem lesões renais agudas, aumento do risco cardiovascular e mortalidade. Diretrizes como as da KDIGO recomendam intervenções como correção de desequilíbrios eletrolíticos, suspensão de medicamentos nefrotóxicos e uso de inibidores de ECA, ARBs e SGLT2, visando estabilizar a função renal e retardar a progressão da DRC. Conclui-se que a gestão eficaz da ACKD requer identificação precoce dos fatores precipitantes, abordagem multidisciplinar e protocolos padronizados, promovendo melhores desfechos clínicos e redução da morbimortalidade associada.
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