Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA; Multidisciplinary Epidemiology and Translational Research in Intensive Care (METRIC) Research Group, Mayo Clinic, Rochester, Minnesota, USA; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Multidisciplinary Epidemiology and Translational Research in Intensive Care (METRIC) Research Group, Mayo Clinic, Rochester, Minnesota, USA; Department of Critical Care Medicine, Affiliated Provincial Hospital of Anhui Medical University, Anhui, China.
Kidney Int. 2017 Sep;92(3):721-728. doi: 10.1016/j.kint.2017.03.020. Epub 2017 May 18.
Recent literature suggests an increase in the incidence of acute kidney injury (AKI). We evaluated population-based trends of AKI over the course of nine years, using a validated electronic health record tool to detect AKI. All adult residents (18 years of age and older) of Olmsted County, Minnesota (MN), admitted to the Mayo Clinic Hospital between 2006 and 2014 were included. The incidence rate of AKI was calculated and temporal trends in the annual AKI incident rates assessed. During the nine-year study period, 10,283, and 41,847 patients were admitted to the intensive care unit or general ward, with 1,740 and 2,811 developing AKI, respectively. The unadjusted incidence rates were 186 and 287 per 100,000 person years in 2006 and reached 179 and 317 per 100,000 person years in 2014. Following adjustment for age and sex, there was no significant change in the annual AKI incidence rate during the study period with a Relative Risk of 0.99 per year (95% confidence interval 0.97-1.01) for intensive care unit patients and 0.993 per year (0.98-1.01) for the general ward patients. Similar results were obtained when the ICD-9 codes or administrative data for dialysis-requiring AKI was utilized to determine incident cases. Thus, despite the current literature that suggests an epidemic of AKI, we found that after adjusting for age and sex the incidence of AKI in the general population remained relatively stable over the last decade.
近期文献提示急性肾损伤（AKI）的发病率增加。我们使用经验证的电子健康记录工具来检测 AKI，评估了 9 年期间 AKI 的人群趋势。明尼苏达州奥姆斯特德县（MN）的所有成年居民（18 岁及以上），凡在 2006 年至 2014 年期间入住梅奥诊所医院的，均被纳入研究。计算 AKI 的发病率，并评估每年 AKI 发病率的时间趋势。在 9 年的研究期间，10283 名和 41847 名患者分别入住重症监护病房或普通病房，分别有 1740 名和 2811 名患者发生 AKI。未校正的发病率在 2006 年分别为每 10 万人年 186 例和 287 例，到 2014 年分别上升至每 10 万人年 179 例和 317 例。调整年龄和性别后，研究期间 AKI 的年发病率无显著变化，重症监护病房患者的相对危险度为每年 0.99（95%置信区间 0.97-1.01），普通病房患者为每年 0.993（0.98-1.01）。当使用 ICD-9 编码或透析所需 AKI 的行政数据来确定病例时，也得到了相似的结果。因此，尽管目前的文献提示 AKI 呈流行趋势，但我们发现，在调整年龄和性别后，过去十年普通人群的 AKI 发病率相对稳定。
