Department of Internal Medicine, School of Medicine, Federal University of Ceará, Ceará, Brazil.
Am J Trop Med Hyg. 2010 Mar;82(3):449-53. doi: 10.4269/ajtmh.2010.09-0571.
The aim of this study was to investigate the factors associated with acute kidney injury (AKI) in patients with visceral leishmaniasis (VL). The study patients had a diagnosis of VL and were admitted to a tertiary hospital. A multivariate analysis was performed to analyze the risk factors for AKI. A total of 224 patients were included. The mean age was 36 +/- 15 years. AKI was observed in 33.9% of cases. Risk factors associated with AKI were male gender (odds ratio [OR] = 2.2; P = 0.03), advanced age (OR = 1.05; P < 0.001), and jaundice (OR = 2.9; P = 0.002). There was an association between amphotericin B use and AKI (OR = 18.4; P < 0.0001), whereas glucantime use was associated with lower incidence of AKI compared with amphotericin B use (OR = 0.05; P < 0.0001). Mortality was 13.3%, and it was higher in AKI patients (30.2%). Therefore, factors associated with AKI were male gender, advanced age, and jaundice. Amphotericin B was an important cause of AKI in VL.
本研究旨在探讨内脏利什曼病（VL）患者急性肾损伤（AKI）的相关因素。研究对象为在三级医院就诊并确诊为 VL 的患者。采用多变量分析方法分析 AKI 的危险因素。共纳入 224 例患者，平均年龄为 36 +/- 15 岁。33.9%的病例发生 AKI。AKI 的相关危险因素为男性（比值比[OR] = 2.2；P = 0.03）、高龄（OR = 1.05；P < 0.001）和黄疸（OR = 2.9；P = 0.002）。两性霉素 B 与 AKI 相关（OR = 18.4；P < 0.0001），而与两性霉素 B 相比，葡萄糖酸锑钠的使用与 AKI 发生率较低相关（OR = 0.05；P < 0.0001）。死亡率为 13.3%，AKI 患者的死亡率更高（30.2%）。因此，与 AKI 相关的因素为男性、高龄和黄疸。两性霉素 B 是 VL 中 AKI 的一个重要原因。
