Gheissari Alaleh, Mehrasa Pardis, Merrikhi Alireza, Madihi Yahya
Isfahan Kidney Diseases Research Center and Department of Pediatric Nephrology, Isfahan University of Medical Sciences, Isfahan, Iran.
J Nephropathol. 2012 Jul;1(2):101-8. doi: 10.5812/nephropathol.7534. Epub 2012 Jul 1.
The etiology of acute kidney injury (AKI) varies in different countries. In addition, the etiology of AKI in hospitalized children is multifactorial. The importance of diagnosing AKI is not only because of short-term high morbidity and mortality rate, but also for its effect on developing chronic kidney disease.
we studied retrospectively AKIs of children who were hospitalized over 10 years in a University hospital.
A retrospective analysis of the medical recorded data of 180 children less than 18 years treated for AKI in Alzahra Hospital, Isfahan, Iran, were performed during the period of March 2001 to February 2011. For each patient, demographic and anthropometric data, laboratory data, electrocardiographic findings, ultrasound results, etiology of AKI and short-term outcomes were recorded.
The male to female ratio was 1.57 to 1. Mean age was 5.28 ± 6.3 (SD) years and the median was 1.8 years. The more frequent age group was children less than 2 years. The mortality rate was 22.2% (40 patients). The mortality was not correlated with age (p= 0.74). Renal replacement therapy was recommended for 62 patients (34.4%). Mean of the first and last glomerular filtration rate (GFR) were 18.33± 1.12 ml/min/1.73 m² and 52.53 ± 2.98 ml/min/1.73 m², respectively. The most common urinary sediment finding in approximately 70% of the patients was either renal epithelial cell or renal cell cast. Increased kidney echogenicity was the most common ultrasound finding (48%). Using ANOVA regression analysis, the etiology of disease was the only predictor of mortality (p=0.0001).
We concluded that the mortality is still high in AKI. Furthermore, the poor outcome (defined as low GFR) are higher among patients with low levels of first GFR and higher RIFLE score.
急性肾损伤（AKI）的病因在不同国家有所不同。此外，住院儿童急性肾损伤的病因是多因素的。诊断急性肾损伤的重要性不仅在于其短期的高发病率和死亡率，还在于其对慢性肾脏病发展的影响。
我们回顾性研究了一家大学医院10多年来住院儿童的急性肾损伤情况。
对2001年3月至2011年2月期间在伊朗伊斯法罕的阿尔扎赫拉医院接受急性肾损伤治疗的180名18岁以下儿童的医疗记录数据进行回顾性分析。记录每位患者的人口统计学和人体测量数据、实验室数据、心电图结果、超声检查结果、急性肾损伤的病因和短期预后。
男女比例为1.57比1。平均年龄为5.28±6.3（标准差）岁，中位数为1.8岁。最常见的年龄组是2岁以下儿童。死亡率为22.2%（40例患者）。死亡率与年龄无关（p = 0.74）。62例患者（34.4%）建议进行肾脏替代治疗。首次和末次肾小球滤过率（GFR）的平均值分别为18.33±1.12 ml/min/1.73 m²和52.53±2.98 ml/min/1.73 m²。约70%的患者最常见的尿沉渣发现是肾上皮细胞或肾细胞管型。肾脏回声增强是最常见的超声检查发现（48%）。使用方差分析回归分析，疾病病因是死亡率的唯一预测因素（p = 0.0001）。
我们得出结论，急性肾损伤的死亡率仍然很高。此外，首次肾小球滤过率水平低且RIFLE评分高的患者预后较差（定义为肾小球滤过率低）。
