Sagheb Mohammad Mahdi, Sharifian Maryam, Roozbeh Jamshid, Moini Maryam, Gholami Khodakaram, Sadeghi Hossein
Shiraz University of Medical Sciences, Internal Medicine Department, Nephrology Division, Nephrourology Research Center, Shiraz, Iran.
Ren Fail. 2008;30(9):831-5. doi: 10.1080/08860220802353785.
At 5:28 a.m. (local time) on December 26, 2003, an earthquake measuring 6.51 on the Richter scale struck the city of Bam in the Kerman Province in southeastern Iran. Among the most important morbid events in survivors were acute renal problems. Clinical findings, laboratory data, and management of the renal victims, all of whom were transferred to Shiraz Hospitals, have been the subject of this analysis.
Medical records of twenty patients with acute renal failure admitted to three university hospitals and one community hospital were reviewed.
Overall, 801 patients were transferred to Shiraz hospitals, of whom 20 (mean age 36.2 +/- 14.8 years, 15 males) developed acute renal failure with mean duration of 14.5 +/- 9.6 days. Total mortality was 21 (2.6%) and acute renal failure mortality was 3 (15%). Seven patients received standard fluid therapy and 13 patients received variable volume treatment. In total, 79 dialysis sessions were performed in 15 patients (mean 5.2, 3.3 +/- 1 sessions per patients). There was a positive correlation between time spent under rubble and peak serum CK (creatine phosphokinase) level (p = 0.035), acute renal failure duration (p = 0.047), and admission potassium levels (p = 0.033). Serum CK level was positively correlated with acute renal failure duration (p = 0.008). Patients who had received standard treatment had significantly shorter duration of acute renal failure (7.1 versus 9.4 days, p = 0.008) and less need for dialysis (1 versus 6, p = 0.007) than patients who were treated variably.
In victims of earthquake, time spent under rubble and peak serum CK level can serve to estimate morbidity, and early standard treatment may decrease renal morbidity.
2003年12月26日凌晨5点28分（当地时间），伊朗东南部克尔曼省巴姆市发生里氏6.51级地震。幸存者中最重要的发病事件是急性肾脏问题。本分析的主题是所有被转移到设拉子医院的肾脏受害者的临床发现、实验室数据及治疗情况。
回顾了三家大学医院和一家社区医院收治的20例急性肾衰竭患者的病历。
总体而言，801名患者被转移到设拉子医院，其中20例（平均年龄36.2±14.8岁，15名男性）发生急性肾衰竭，平均病程为14.5±9.6天。总死亡率为21例（2.6%），急性肾衰竭死亡率为3例（15%）。7例患者接受了标准液体疗法，13例患者接受了可变容量治疗。15例患者共进行了79次透析（平均5.2次，每位患者3.3±1次）。被埋在废墟下的时间与血清肌酸磷酸激酶（CK）峰值水平（p = 0.035）、急性肾衰竭持续时间（p = 0.047）和入院时血钾水平（p = 0.033）之间存在正相关。血清CK水平与急性肾衰竭持续时间呈正相关（p = 0.008）。与接受可变治疗的患者相比，接受标准治疗的患者急性肾衰竭持续时间明显更短（7.1天对9.4天，p = 0.008），透析需求更少（1次对6次，p = 0.007）。
在地震受害者中，被埋在废墟下的时间和血清CK峰值水平可用于估计发病率，早期标准治疗可能会降低肾脏发病率。
