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需要透析的急性肾损伤患者的临床特征及预后——来自一个发展中国家血液透析单位的经验

Clinical profile and outcome of patients with acute kidney injury requiring dialysis-an experience from a haemodialysis unit in a developing country.

作者信息

Ibrahim Ahmed, Ahmed Momina M, Kedir Seman, Bekele Delayehu

机构信息

Moyale Hospital, Oromia Regional State, Ethiopia.

Department of Internal Medicine, Nephrology Unit, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.

出版信息

BMC Nephrol. 2016 Jul 22;17(1):91. doi: 10.1186/s12882-016-0313-8.

Abstract

BACKGROUND

The first government funded and sustainable dialysis unit was established in Ethiopia at Saint Paul's Hospital Millennium Medical College (SPHMMC). This has led to the development of a unique cohort of patients about which very little is known. This study was conducted to describe the clinical profile and outcome of adult Acute Kidney Injury (AKI) patients treated with intermittent haemodialysis at the dialysis center of SPHMMC.

METHODS

A retrospective review of clinical records of cases of AKI who required haemodialysis support during the time period from August 1, 2013 to February 1, 2015 was conducted.

RESULTS

A total of 151 cases AKI requiring dialysis were included for the study. Overall, the patients were generally younger with a mean age of 36.7 years and thus with few premorbid conditions. The most common causes of AKI were hypovolemia (22.5 %), acute glomerulonephritis (AGN) (21.9 %) and pregnancy related causes (18.5 %). Nearly a third (29.1 %) of patients succumbed to the AKI.

CONCLUSION

Infections, AGN, obstetric causes and nephrotoxins were the primary causes of dialysis requiring AKI. Most of these causes can be prevented with simple interventions such as health education on oral rehydration, quality prenatal and emergency obstetric care, appropriate management of infections and taking appropriate precautions when prescribing potentially nephrotoxic medications.

摘要

背景

埃塞俄比亚在圣保罗医院千年医学院(SPHMMC)建立了首个由政府资助且可持续运营的透析单元。这促成了一批独特患者群体的形成,而目前对他们的了解非常有限。本研究旨在描述在SPHMMC透析中心接受间歇性血液透析治疗的成年急性肾损伤(AKI)患者的临床特征及预后。

方法

对2013年8月1日至2015年2月1日期间需要血液透析支持的AKI病例的临床记录进行回顾性分析。

结果

本研究共纳入151例需要透析的AKI病例。总体而言,患者普遍较为年轻,平均年龄为36.7岁,因此合并症较少。AKI最常见的病因是血容量不足(22.5%)、急性肾小球肾炎(AGN)(21.9%)以及与妊娠相关的病因(18.5%)。近三分之一(29.1%)的患者死于AKI。

结论

感染、AGN、产科病因和肾毒素是需要透析的AKI的主要病因。通过一些简单的干预措施,如口服补液健康教育、高质量的产前和急诊产科护理、感染的恰当管理以及在开具可能具有肾毒性的药物时采取适当预防措施等,这些病因大多是可以预防的。

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