无心脏病的急性肾衰竭患者的预后
Prognosis of patients with acute renal failure without cardiopathy.
作者信息
Gallego N, Pérez-Caballero C, Gallego A, Estepa R, Liaño F, Ortuño J
机构信息
Servicio de Nefrología, Hospital Ramón y Cajal, Carretera de Colmenar Km 9.1, 28034 Madrid, Spain.
出版信息
Arch Dis Child. 2001 Mar;84(3):258-60. doi: 10.1136/adc.84.3.258.
BACKGROUND
The outcome for children with acute renal failure (ARF) may be poor. However, relatively few published studies have considered prognosis of these patients.
METHODS
We prospectively studied, from 1978 to 1998, 92 such children without heart disease to try to identify risk factors for mortality.
RESULTS
Forty five per cent of children with tumours, shock, and other causes died compared with none of those with a primary urinary tract related problem. ARF did not seem to be the cause of death in any case. Univariate analysis showed that in the non-primary urinary problem group (55 cases), patients with hypotension, high values of BUN or creatinine, or who needed mechanical ventilation or dialysis, had a poor outcome. Multivariate analysis showed that probability of death can be estimated using the following score: -0.02 + 0.28 (hypotension) + 0.19 (ventilation) + 0.27 (dialysis) + 0.01 (BUN).
CONCLUSIONS
Mortality of patients with ARF was related to aetiology, the need for dialysis and/or ventilator use, hypotension, and BUN values.
背景
急性肾衰竭（ARF）患儿的预后可能较差。然而，已发表的研究中相对较少考虑这些患者的预后情况。
方法
从1978年至1998年，我们对92名无心脏病的此类患儿进行了前瞻性研究，试图确定死亡的危险因素。
结果
患有肿瘤、休克和其他病因的患儿中有45%死亡，而原发性泌尿系统相关问题的患儿无一死亡。在任何病例中，ARF似乎都不是死亡原因。单因素分析显示，在非原发性泌尿系统问题组（55例）中，出现低血压、血尿素氮（BUN）或肌酐值高，或需要机械通气或透析的患者预后较差。多因素分析显示，可使用以下评分来估计死亡概率：-0.02 + 0.28（低血压）+ 0.19（通气）+ 0.27（透析）+ 0.01（BUN）。
结论
ARF患者的死亡率与病因、是否需要透析和/或使用呼吸机、低血压以及BUN值有关。
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