肺动脉高压合并急性右侧心力衰竭住院患者急性肾损伤的发生率、相关因素和后果。
Incidence, correlates, and consequences of acute kidney injury in patients with pulmonary arterial hypertension hospitalized with acute right-side heart failure.
机构信息
Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California 94305, USA.
出版信息
J Card Fail. 2011 Jul;17(7):533-9. doi: 10.1016/j.cardfail.2011.03.003. Epub 2011 Apr 22.
BACKGROUND
Though much is known about the prognostic influence of acute kidney injury (AKI) in left-side heart failure, much less is known about AKI in patients with pulmonary arterial hypertension (PAH).
METHODS AND RESULTS
We identified consecutive patients with PAH who were hospitalized at Stanford Hospital for acute right-side heart failure. AKI was diagnosed according to the criteria of the Acute Kidney Injury Network. From June 1999 to June 2009, 105 patients with PAH were hospitalized for acute right-side heart failure (184 hospitalizations). AKI occurred in 43 hospitalizations (23%) in 34 patients (32%). The odds of developing AKI were higher among patients with chronic kidney disease (odds ratio [OR] 3.9, 95% confidence interval [CI] 1.8-8.5), high central venous pressure (OR 1.8, 95% CI 1.1-2.4, per 5 mm Hg), and tachycardia on admission (OR 4.3, 95% CI 2.1-8.8). AKI was strongly associated with 30-day mortality after acute right-side heart failure hospitalization (OR 5.3, 95% CI 2.2-13.2).
CONCLUSIONS
AKI is relatively common in patients with PAH and associated with a short-term risk of death.
背景
尽管人们对左心衰竭患者急性肾损伤（AKI）的预后影响有了很多了解，但对肺动脉高压（PAH）患者的 AKI 了解甚少。
方法和结果
我们确定了连续因急性右心衰竭住院的 PAH 患者。根据急性肾损伤网络的标准诊断 AKI。1999 年 6 月至 2009 年 6 月，105 例 PAH 患者因急性右心衰竭住院（184 次住院）。34 例患者中有 43 次住院（23%）发生 AKI。慢性肾脏病患者发生 AKI 的几率更高（比值比[OR]3.9，95%置信区间[CI]1.8-8.5），中心静脉压较高（OR 1.8，95% CI 1.1-2.4，每 5mmHg），入院时心动过速（OR 4.3，95% CI 2.1-8.8）。急性右心衰竭住院后 AKI 与 30 天死亡率密切相关（OR 5.3，95% CI 2.2-13.2）。
结论
AKI 在 PAH 患者中较为常见，并与短期死亡风险相关。
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