Bucuvic Edwa Maria, Ponce Daniela, Balbi André Luis
Universidade Estadual Júlio de Mesquita Filho, SP.
Rev Assoc Med Bras (1992). 2011 Mar-Apr;57(2):158-63. doi: 10.1590/s0104-42302011000200012.
This study aims to evaluate the outcome of AKI patients caused by acute tubular necrosis admitted in clinical and surgical units of Botucatu Medical School University Hospital - UNESP.
This is a retrospective cohort study with 477 adult patients were observed from January 2001 to December 2008. AKI was defined according to serum creatinine levels as proposed by Acute Kidney Injury Network (AKIN).
The mean age was 65.5 ± 162 years. The majority of the patients were males (62%) older than 60 years (65.2%). Diabetes mellitus was diagnosed in 61.9%, high blood pressure in 44.4% and chronic kidney disease 21.8% of the patients. Death occurred 66% of dialysis requirement, critical care unit admission, age > 60 years and lower attendance time by nephrologists were significant and independently associated with death risk. The renal recorery among survivors was of 96.9%.
This work shows that the evolution of AKI patients from clinical and surgical wards is similar to literature. However, the high mortality of the group shows the necessity of identifying risk factors for the development of AKI in these patients and training staff assistant for the early diagnosis of this syndrome.
本研究旨在评估在巴西圣保罗州立大学医学院博图卡图大学医院临床和外科病房收治的急性肾小管坏死所致急性肾损伤(AKI)患者的治疗结果。
这是一项回顾性队列研究,观察了2001年1月至2008年12月期间的477例成年患者。根据急性肾损伤网络(AKIN)提出的标准,依据血清肌酐水平定义AKI。
平均年龄为65.5±162岁。大多数患者为男性(62%),年龄超过60岁(65.2%)。61.9%的患者诊断为糖尿病,44.4%患有高血压,21.8%患有慢性肾脏病。66%的患者死亡需要透析、入住重症监护病房、年龄>60岁以及肾病科医生的就诊时间较短与死亡风险显著且独立相关。幸存者中的肾脏恢复率为96.9%。
这项研究表明,临床和外科病房中AKI患者的病情发展与文献报道相似。然而,该组患者的高死亡率表明有必要识别这些患者发生AKI的危险因素,并培训医护人员对该综合征进行早期诊断。