Magden K, Yildirim I, Kutu Me, Ozdemir Mc, Peynir S, Altas A, Yildiz G, Hur E
Department of Nephrology, Bulent Ecevit University Medical School, Zonguldak, Turkey.
Department of Internal Medicine, Bulent Ecevit University Medical School, Zonguldak, Turkey.
Hippokratia. 2013 Jul;17(3):239-42.
Acute kidney injury (AKI) may result in complete recovery in some of the patients and partial recovery in others. AKI episodes may accelerate the progression to chronic kidney disease and end-stage renal failure, while risk for morbidity and mortality is high following AKI. Discharge of patients from the hospital, independently from dialysis is a crucial outcome. Many patients without a need for dialysis, require follow-up for various durations and different treatments. The objective of this study was to compare mean recovery time of the patients followed-up due to prerenal, renal and postrenal AKIs.
In this prospective observational study, a total of 159 patients hospitalized in Bulent Ecevit Hospital, clinic of nephrology or monitored in the other wards and intensive care unit due to AKI, between June 2011 and January 2012, were enrolled. The cases were divided into three groups as prerenal, renal and postrenal, and monitored with the daily visits and renal function testing.
Prerenal AKI was seen by 54%, while renal AKI was observed by 34% and post-renal AKI by 12%. Incidence of chronic kidney disease was 17.6%. Totally 43 patients required hemodialysis (27%). Of these patients, 23 were in the prerenal AKI (53.4%), 15 in the renal AKI (34.8%) and 5 (11.6%) in the postrenal AKI group. Blood urea nitrogen (BUN) and creatinine levels were dropped to the basal values only in the prerenal AKI group, on the seventh day of treatment. These levels remained higher in the postrenal and renal groups on the 7th day of treatment compared to the basal values. BUN levels decreased to the normal values on average 7th day in the postrenal, while remained higher in the renal group.
Prerenal AKI patients recovered in seven days with a proper treatment, although AKI patients due to other reasons should be followed-up for a longer time.
急性肾损伤(AKI)在部分患者中可能完全恢复,而在其他患者中则可能部分恢复。AKI发作可能加速慢性肾脏病和终末期肾衰竭的进展,同时AKI后的发病和死亡风险很高。患者出院(无论是否依赖透析)是一个关键结局。许多无需透析的患者需要不同时长的随访和不同的治疗。本研究的目的是比较因肾前性、肾性和肾后性AKI接受随访患者的平均恢复时间。
在这项前瞻性观察性研究中,纳入了2011年6月至2012年1月期间因AKI在布伦特·埃杰维特医院肾脏病科住院或在其他病房及重症监护室接受监测的159例患者。病例分为肾前性、肾性和肾后性三组,通过每日查房和肾功能检测进行监测。
肾前性AKI占54%,肾性AKI占34%,肾后性AKI占12%。慢性肾脏病的发生率为17.6%。共有43例患者需要血液透析(27%)。其中,肾前性AKI组有23例(53.4%),肾性AKI组有15例(34.8%),肾后性AKI组有5例(11.6%)。仅在肾前性AKI组中,治疗第7天时血尿素氮(BUN)和肌酐水平降至基础值。与基础值相比,治疗第7天时肾后性和肾性组的这些水平仍较高。肾后性组中BUN水平平均在第7天降至正常,而肾性组中仍较高。
肾前性AKI患者经适当治疗7天即可恢复,不过其他原因导致的AKI患者应随访更长时间。