Lu Ren-hua, Fang Yan, Gao Jia-yuan, Cai Hong, Zhu Ming-li, Zhang Min-fang, Dai Hui-li, Zhang Wei-ming, Ni Zhao-hui, Qian Jia-Qi, Yan Yu-Cheng
Nephrology Division, Renji Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai 200127, China.
Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2011 Jul;23(7):413-7.
To investigate the epidemiology and the risk factors of acute kidney injury (AKI) in hospitalized patients in order to help clinicians better understand and prevent AKI.
All patients hospitalized in Renji Hospital of Shanghai Jiao Tong University, which is a three-level General Hospital in Shanghai, during January to December of 2008 were screened by Lab Administration Network. Study group was comprised of the patients with full clinical data of AKI, as defined by Acute Kidney Injury Network (AKIN). The incidence, etiology and distribution characteristics of hospitalized patients with AKI were retrospectively analyzed. Logistic regression analysis was used to investigate the risk factors in severity of AKI.
Nine hundred and thirty-four patients suffering from AKI for 1 001 episodes were enrolled. The incidence of AKI in hospitalized patients was 2.4% (934/38 734). The ratio of male to female was 1.88:1. The mean age was (60.82 ± 16.94) years old. Higher incidence was seen with an increase in age. Three hundred and thirty-one(35.4%) patients with AKI were found in medical department, 592(63.4%) patients in surgical department and 11(1.2%) patients in department of gynecologic and obstetrics. Analysis of the causes of AKI showed that pre-AKI accounted for 52.0%, followed by renal parenchyma AKI (44.7%) and postrenal AKI (3.3%). The most common reason for AKI was acute tubular necrosis (ATN, 37.5%), followed by absolute (33.6%) and relative inadequacy of blood volume (13.4%). Multivariate logistic regression analysis showed that chronic kidney disease (CKD) [odds ratio (OR)=2.085, 95% confidence interval (95%CI): 1.536-2.830,P<0.01], renal injurious drugs (OR=1.438, 95%CI: 1.087-1.901 ,P<0.05), and failure of organs other than kidney (OR=1.327, 95%CI: 1.014-1.737,P<0.05) were independent risk factors for stage II-III AKI.
AKI is one of the most common clinical syndromes in hospitalized patients. With the increase of age, the incidence increases gradually. The most common reasons for hospitalized AKI are pre-AKI and ATN. CKD, renal injurious drugs and failure of other organs are independent risk factors of medium to serious AKI.
调查住院患者急性肾损伤（AKI）的流行病学及危险因素，以帮助临床医生更好地理解和预防AKI。
通过实验室管理网络对2008年1月至12月在上海交通大学附属仁济医院（上海市一家三级综合性医院）住院的所有患者进行筛查。研究组由符合急性肾损伤网络（AKIN）定义的具有AKI完整临床资料的患者组成。回顾性分析住院AKI患者的发病率、病因及分布特征。采用Logistic回归分析探讨AKI严重程度的危险因素。
共纳入934例发生1001次AKI的患者。住院患者AKI的发病率为2.4%（934/38734）。男女比例为1.88:1。平均年龄为（60.82±16.94）岁。发病率随年龄增长而升高。内科有331例（35.4%）AKI患者，外科有592例（63.4%），妇产科有11例（1.2%）。AKI病因分析显示，肾前性AKI占52.0%，其次是肾实质性AKI（44.7%）和肾后性AKI（3.3%）。AKI最常见的原因是急性肾小管坏死（ATN，37.5%），其次是血容量绝对（33.6%）和相对不足（13.4%）。多因素Logistic回归分析显示，慢性肾脏病（CKD）[比值比（OR）=2.085，95%置信区间（95%CI）：1.536 - 2.830，P<0.01]、肾毒性药物（OR=1.438，95%CI：1.087 - 1.901，P<0.05）及非肾脏器官功能衰竭（OR=1.327，95%CI：1.014 - 1.737，P<0.05）是Ⅱ - Ⅲ期AKI的独立危险因素。
AKI是住院患者最常见的临床综合征之一。随着年龄的增加，发病率逐渐升高。住院AKI最常见的原因是肾前性AKI和ATN。CKD、肾毒性药物及其他器官功能衰竭是中重度AKI的独立危险因素。
