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全国需要透析的急性肾损伤(NEP-AKI-D)研究:设计与方法。

Nationwide epidemiology and prognosis of dialysis-requiring acute kidney injury (NEP-AKI-D) study: Design and methods.

作者信息

Shiao Chih-Chung, Wu Pei-Chen, Wu Vin-Cent, Lin Jui-Hsiang, Pan Heng-Chih, Yang Ya-Fei, Lai Tai-Shuan, Huang Tao-Min, Wu Che-Hsiung, Yang Wei-Shun, Wu Chih-Jen, Kao Chih-Chin, Sun Chiao-Yin, Huang Chun-Te, Lee Kuo-Hua, Lin Chan-Yu, Chen Te-Chuan, Hu Fu-Chang, Liou Hung-Hsiang, Lu Kuo-Cheng, Chien Kuo-Liong, Wang Jian-Jhong, Kan Wei-Chih, Kuo Feng-Chi, Lin Hugo You-Hsien, Chen Cheng-Min, You Zi-Hong, Tsai Jen-Pi, Weng Chih-Jen, Chen Hung-Yuan, Chang Chao-Fu, Hsu Wen-Ding, Wu Mai-Szu, Huang Chiu-Ching, Wu Kwan-Dun

机构信息

Saint Mary's Hospital Luodong and Saint Mary's Medicine, Nursing and Management College, Yilan.

Mackay Memorial Hospital.

出版信息

Nephrology (Carlton). 2016 Sep;21(9):758-64. doi: 10.1111/nep.12670.

Abstract

AIM

Acute kidney injury (AKI) carries an increasing incidence rate worldwide and increases the risk of developing end-stage renal disease (ESRD) as well as the medical expenses during the post-AKI course. The Taiwan Consortium for Acute Kidney Injury and Renal Diseases (CAKs) has thus launched a nationwide epidemiology and prognosis of dialysis-requiring acute kidney injury (NEP-AKI-D) study, which prospectively enrols critically ill patients with AKI. Through thoroughly evaluating the risk and prognostic factors of AKI, we hope to lower the incidence of AKI and ESRD from the perspective of AKI-ESRD interaction.

METHODS

The CAKs includes 30 hospitals which distribute widely through the four geographical regions (north, middle, south, and east) of Taiwan, and have a 1:1 ratio of medical centres to regional hospitals in each region. The NEP-AKI-D study enrols intensive care unit-based AKI patients who receive dialysis in the four seasonal sampled months (October 2014, along with January, April, and July 2015) in the included hospitals. The collected data include demographic information, pertaining laboratory results, dialysis settings and patient outcomes. The data are uploaded in a centre website and will be audited by on-site principal investigators, computer logic gates, and the CAKs staffs. The outcomes of interest are in-hospital mortality, dialysis-dependency and readmission rate within 90 days after discharge.

CONCLUSION

The NEP-AKI-D study enrols a large number of representative AKI patients throughout Taiwan. The results of the current study are expected to provide more insight into the risk and prognostic factors of AKI and further attenuated further chronic kidney disease transition.

摘要

目的

急性肾损伤(AKI)在全球范围内的发病率不断上升,增加了发展为终末期肾病(ESRD)的风险以及急性肾损伤后病程中的医疗费用。因此,台湾急性肾损伤与肾脏疾病联盟(CAKs)开展了一项全国性的需要透析的急性肾损伤的流行病学和预后(NEP-AKI-D)研究,该研究前瞻性地纳入了危重症急性肾损伤患者。通过全面评估急性肾损伤的风险和预后因素,我们希望从急性肾损伤-终末期肾病相互作用的角度降低急性肾损伤和终末期肾病的发病率。

方法

CAKs包括30家医院,这些医院广泛分布于台湾的四个地理区域(北部、中部、南部和东部),每个区域的医学中心与地区医院的比例为1:1。NEP-AKI-D研究纳入在纳入医院中在四个季节性采样月份(2014年10月以及2015年1月、4月和7月)接受透析的基于重症监护病房的急性肾损伤患者。收集的数据包括人口统计学信息、相关实验室结果、透析设置和患者结局。数据上传至中心网站,并将由现场主要研究者、计算机逻辑门和CAKs工作人员进行审核。感兴趣的结局包括住院死亡率、透析依赖以及出院后90天内再次入院率。

结论

NEP-AKI-D研究在全台湾纳入了大量具有代表性的急性肾损伤患者。目前的研究结果有望为急性肾损伤的风险和预后因素提供更多见解,并进一步减轻慢性肾病的进展。

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