Division of Intensive Care Unit, Chiba Hokusoh Hospital, Nippon Medical School, 1715 Kamagari, Inbamura, Inbagun, Chiba 270-1694, Japan.
Eur J Heart Fail. 2010 Jan;12(1):32-7. doi: 10.1093/eurjhf/hfp169.
The clinical course including the outcome of acute decompensated heart failure (ADHF) correlates with renal dysfunction, but the evaluation of renal function has not yet been standardized. We therefore investigated the relationship between the prognosis of ADHF and acute kidney injury (AKI) evaluated using the risk, injury, failure, loss, end stage (RIFLE) criteria.
This study assessed 376 consecutive patients with ADHF admitted to the intensive care unit (ICU) (mean age 71.6 years; 238 male). The underlying aetiology was ischaemic heart disease, hypertensive heart disease, cardiomyopathy, valvular diseases, and 'other' in 124, 70, 60, 107, and 15 patients, respectively. We defined AKI according to the RIFLE criteria, and the most severe RIFLE classifications during hospitalization were adopted to assess patient outcomes. The in-hospital mortality was significantly higher among patients with AKI (29 of 275; 10.5%) than in those without AKI (1 of 101; 1.0%, P = 0.0010). Both ICU and hospital stays were longer for patients with AKI (8.8 +/- 15.4 vs. 48.6 +/- 47.6 days), than for patients without (5.0 +/- 2.8 vs. 25.7 +/- 16.8 days, P < 0.05 and P < 0.001).
Acute kidney injury evaluated by the RIFLE criteria was associated with a poorer outcome for patients with ADHF.
急性失代偿性心力衰竭（ADHF）的临床病程包括结局与肾功能障碍相关，但肾功能的评估尚未标准化。因此，我们使用风险、损伤、衰竭、丧失和终末期（RIFLE）标准评估 ADHF 的预后与急性肾损伤（AKI）之间的关系。
本研究评估了 376 例连续因 ADHF 入住重症监护病房（ICU）的患者（平均年龄 71.6 岁；238 名男性）。潜在病因分别为缺血性心脏病、高血压性心脏病、心肌病、瓣膜疾病和其他疾病，分别在 124、70、60、107 和 15 例患者中。我们根据 RIFLE 标准定义 AKI，并采用住院期间最严重的 RIFLE 分类评估患者的结局。AKI 患者的院内死亡率明显高于无 AKI 患者（275 例中的 29 例[10.5%]比 101 例中的 1 例[1.0%]，P=0.0010）。AKI 患者的 ICU 入住时间和住院时间均长于无 AKI 患者（8.8±15.4 比 5.0±2.8 天；P<0.05 和 P<0.001）。
RIFLE 标准评估的 AKI 与 ADHF 患者的不良结局相关。
