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儿童急性肾衰竭(ARF)死亡率的相关因素。

Factors associated with mortality in acute renal failure (ARF) in children.

作者信息

Loza Reyner, Estremadoyro Luis, Loza César, Cieza Javier

机构信息

Nephrology Unit, Universidad Peruana Cayetano Heredia, Hospital Cayetano Heredia, Av. Honorio Delgado s/n, San Martín de Porras, Lima, Peru.

出版信息

Pediatr Nephrol. 2006 Jan;21(1):106-9. doi: 10.1007/s00467-005-2038-y. Epub 2005 Oct 27.

Abstract

OBJECTIVE

To assess the factors that affect the mortality in acute renal failure (ARF) in children.

PATIENTS AND METHODS

We studied 149 patients with ARF and described the findings by age, gender, pathophysiological mechanism of renal damage, and type of renal damage, which can be oligoanuric and/or septic. We used multiple logistic analysis, Cox analysis for survival, and Kaplan-Meier curves.

RESULTS

The male/female ratio was 91/58. The most affected age groups were newborns (44.3%) and infants (37.6%). The ARF mechanism was ischemic in 87 cases (58%) and the most frequent clinical type was nonoliguric in 118 cases (79.2%). In the multiple logistic regression analysis, only oliguria (P=0.07) and age group (P=0.049) were associated with mortality. In the survival analysis using the Cox method, oliguria (P=0.003) and sepsis (P=0.03) were associated with mortality. The survival curves showed that the cumulative probability of dying in the first 10, 20, or 40 days after the event was 75, 70, and 45% respectively. When oliguria was present, the survival at day 10 was 47% and when sepsis was present it was 68%.

CONCLUSION

Oliguria, age, and sepsis are factors associated with mortality in children with ARF.

摘要

目的

评估影响儿童急性肾衰竭(ARF)死亡率的因素。

患者与方法

我们研究了149例ARF患者,并按年龄、性别、肾损伤的病理生理机制以及肾损伤类型(少尿型和/或脓毒症型)描述了研究结果。我们采用了多元逻辑分析、生存的Cox分析以及Kaplan-Meier曲线。

结果

男女比例为91/58。受影响最严重的年龄组是新生儿(44.3%)和婴儿(37.6%)。87例(58%)ARF的机制为缺血性,最常见的临床类型为非少尿型,共118例(79.2%)。在多元逻辑回归分析中,只有少尿(P = 0.07)和年龄组(P = 0.049)与死亡率相关。在使用Cox方法的生存分析中,少尿(P = 0.003)和脓毒症(P = 0.03)与死亡率相关。生存曲线显示,事件发生后第10、20或40天的累积死亡概率分别为75%、70%和45%。出现少尿时,第10天的生存率为47%;出现脓毒症时,第10天的生存率为68%。

结论

少尿、年龄和脓毒症是与儿童ARF死亡率相关的因素。

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