混合重症监护病房患者肾清除率增加的流行病学

Epidemiology of augmented renal clearance in mixed ICU patients.

作者信息

De Waele J J, Dumoulin A, Janssen A, Hoste E A

机构信息

Department of Critical Care Medicine, Ghent University Hospital, Ghent, Belgium -

出版信息

Minerva Anestesiol. 2015 Oct;81(10):1079-85. Epub 2015 Feb 20.

PMID:25697881

Abstract

BACKGROUND

Augmented renal clearance (ARC) or renal hyperfiltration is increasingly reported in intensive care unit (ICU) patients. The goal of this analysis was to study the epidemiology of ARC in a cohort of mixed ICU patients

METHODS

Single center retrospective cohort study of adult ICU patients (12/2008-2/2010). When data were available, urinary creatinine clearance (CLCR) was calculated for all patients throughout their ICU stay. ARC was defined as a body surface adjusted CLCR≥130 mL/min/1.73m2. We sought to study the incidence of ARC and identify patient characteristics associated with ARC.

RESULTS

A total of 1081 patients were included in the analysis, generating 4472 ICU patient days. Median age was 62 y (IQR 50-72), and 63% were male. The initial CLCR was 86 (39-151) mL/min and the maximal CLCR was 145 (76-237) mL/min. ARC occurred in 55.8% of patients, and was about as frequent in men and women (37%% vs. 35%%, P=0.73). Patients with ARC were younger (57 vs. 67 years, P<0.001) and were less frequently treated with vasopressors (27% vs. 39%, P<0.01). ARC incidence was 36.6 ARC days per 100 ICU days. ARC throughout the ICU stay occurred in 32.8% of patients.

CONCLUSION

ARC was a frequent finding in this cohort of ICU patients, with more than half of the patient expressing ARC at least once during their ICU stay, and an incidence of 36.6 ARC days/100 patient days.

摘要

背景

强化肾清除率（ARC）或肾超滤在重症监护病房（ICU）患者中的报道日益增多。本分析的目的是研究一组混合ICU患者中ARC的流行病学情况。

方法

对成年ICU患者进行单中心回顾性队列研究（2008年12月至2010年2月）。当数据可用时，计算所有患者在整个ICU住院期间的尿肌酐清除率（CLCR）。ARC定义为经体表面积校正的CLCR≥130 mL/min/1.73m²。我们试图研究ARC的发生率，并确定与ARC相关的患者特征。

结果

共有1081例患者纳入分析，产生4472个ICU患者日。中位年龄为62岁（四分位间距50 - 72岁），63%为男性。初始CLCR为86（39 - 151）mL/min，最大CLCR为145（76 - 237）mL/min。55.8%的患者发生ARC，男性和女性的发生率相近（37%对35%，P = 0.73）。发生ARC的患者较年轻（57岁对67岁，P < 0.001），使用血管升压药治疗的频率较低（27%对39%，P < 0.01）。ARC发生率为每100个ICU日36.6个ARC日。32.8%的患者在整个ICU住院期间均出现ARC。