实用医学杂志 ›› 2022, Vol. 38 ›› Issue (1): 101-105.doi: 10.3969/j.issn.1006⁃5725.2022.01.019

• 调查研究 • 上一篇    下一篇

单中心急性肾损伤的短期预后调查分析

刘梅1 莫曼秋2 谭琳2 蒋玲2 潘小洁2 廖蕴华2 潘玲2   

  1. 1 钦州市第二人民医院肾内科(广西钦州535099);2 广西医科大学第一附属医院肾内科(南宁530021)

  • 出版日期:2022-01-10 发布日期:2022-01-10
  • 通讯作者: 潘玲 E⁃mail:nnpanling008@sina.com
  • 基金资助:
    广西自然科学基金(编号:2018GXNSFBA050040);广西科学研究与技术开发项目(编号:桂科攻 1598011⁃6)

Short⁃term prognosis of acute kidney injury:A single center analysis

LIU Mei*,MO Manqiu,TAN Lin, JIANG Ling,PAN Xiaojie,LIAO Yunhua,PAN Ling.    

  1. Department of Nephrology,the Second People′s Hospital of Qinzhou,Qinzhou 535099,China

  • Online:2022-01-10 Published:2022-01-10
  • Contact: PAN Ling E⁃mail:nnpanling008@sina.com

摘要:

目的 调查单中心的急性肾损伤(AKI)患者的患病情况及短期预后,分析 AKI 不良预后的 影响因素。方法 回顾性分析 2015 1 1 日至 2018 12 31 日在我院住院的 AKI 患者的临床资料,从诊断 AKI 日期随访至诊断 AKI 当次住院的出院日期。结果 纳入研究的 AKI 患者 2 807 例,7.8% AKI 者死亡,20.4%肾功无好转或恶化,35.9%肾功部分恢复,22.1%肾功完全恢复。AKI 1 期、2 期及 3 期比例 分别为 27.0%、21.9% 51.1%,分期越重病死率越高。多因素回归分析提示:年龄、住 ICU、心衰、多器官功 能障碍综合征(multiple organ dysfunction syndrome,MODS)、休克、酸中毒、非肾内科干预是AKI 全因死亡的 危险因素(均 P < 0.05);除上述因素外,吸烟、蛋白尿、呼衰是AKI肾功能不恢复的危险因素(均 P < 0.05)。 生存分析表明,肾内科干预组的预后累积生存率显著高于非肾内科干预组(P < 0.001)。结论 AKI病死率 较高,肾功恢复率偏低。年龄、住ICU、心功能、MODS、休克、酸中毒和是否肾内科干预是AKI短期预后的影 响因素,而肾内科干预有助于改善不良预后。

关键词: 急性肾损伤,  , 短期预后,  , 危险因素

Abstract:

Objective To investigate the prevalence and short⁃term prognosis of patients with acute kid⁃ ney injury(AKI),and to explorethe risk factors of poor prognosis. Methods We conducted a single center study. Clinical data of AKI patients from January 1,2015 to December 31,2018 were analyzed retrospectively. And the follow⁃up was implemented from the confirmation of AKI to the discharge. Results A total of 2 807 patients with AKI were enrolled in the study. Of the total,7.8% of the patients died;20.4% had no recovery of renal function 35.9% partial recovery,and 22.1% complete recovery.The rate of AKI stage 1,2,and 3 was 27.0%,21.9%,and 51.1%,respectively. The higher the stage,the higher the fatality rate. Multivariate regression analysis showed that advanced age,ICU admission,cardiac insufficiency,MODS,and shock,acidosis,and non ⁃nephrological inter⁃ ventions were risk factors for all⁃cause death from AKI(all P < 0.05). In addition,smoking,proteinuria,and respiratory failure are risk factors for the failure of renal function recovery in AKI(all P < 0.05). Survival analysis showed that patients with nephrology intervention had a lower risk of renal failure than those without(P < 0.001). Conclusion AKI leads tohigher mortality and lower renal function recovery rate. Important factors affecting AKI short⁃term prognosis include age,ICU admission,cardiac insufficiency,MODS,shock,acidosis,and with nephrology intervention or not. Nnephrology intervention helps improve the poor prognosis.

Key words:

acute kidney injury, short?term prognosis, risk factors

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