Chan Melanie, Ostermann Marlies
Department of Critical Care, King's College London, King's Health Partners, Guy's & St Thomas' Foundation Hospital, London SE1 7EH, UK.
Crit Care Res Pract. 2013;2013:715807. doi: 10.1155/2013/715807. Epub 2013 May 9.
Patients with end-stage renal disease (ESRD) experience higher rates of hospitalisation, cardiovascular events, and all-cause mortality and are more likely to require admission to the intensive care unit (ICU) than patients with normal renal function. Sepsis and cardiovascular diseases are the most common reasons for ICU admission. ICU mortality rates in patients requiring chronic hemodialysis are significantly higher than for patients without ESRD; however, dialysis patients have a better ICU outcome than those with acute kidney injury (AKI) requiring renal replacement therapy suggesting that factors other than loss of renal function contribute to their prognosis. Current evidence suggests, the longer-term outcomes after discharge from ICU may be favourable and that long-term dependence on dialysis should not prejudice against prompt referral or admission to ICU.
与肾功能正常的患者相比,终末期肾病(ESRD)患者的住院率、心血管事件发生率和全因死亡率更高,且更有可能需要入住重症监护病房(ICU)。脓毒症和心血管疾病是入住ICU最常见的原因。需要长期血液透析的患者的ICU死亡率显著高于没有ESRD的患者;然而,透析患者的ICU结局比需要肾脏替代治疗的急性肾损伤(AKI)患者更好,这表明除肾功能丧失外的其他因素也会影响其预后。目前的证据表明,从ICU出院后的长期预后可能较好,长期依赖透析不应妨碍及时转诊或入住ICU。