心脏外科手术相关急性肾损伤对中国患者长期结局的影响：一项历史性队列研究。

Effect of Cardiac Surgery-Associated Acute Kidney Injury on Long-Term Outcomes of Chinese Patients: A Historical Cohort Study.

机构信息

Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital), Nanjing, China.

出版信息

Blood Purif. 2017;44(3):227-233. doi: 10.1159/000478967. Epub 2017 Sep 6.

DOI:10.1159/000478967

PMID:28873378

Abstract

BACKGROUND/AIMS: To evaluate the long-term outcomes of Chinese patients with cardiac surgery-associated acute kidney injury (CSA-AKI).

METHODS

Patients who underwent cardiac surgery with a median 3-year follow-up were enrolled. The long-term survival rate and the incidence of chronic kidney disease (CKD) were recorded, and related risk factors were analyzed.

RESULTS

Of all 1,363 patients, 457 (33.5%) developed CSA-AKI. The AKI patients had a lower 3-year survival rate (88.8 vs. 97.2%, respectively, p < 0.001) and a higher incidence of CKD stages 3-5 (9.9 vs. 2.3%, respectively, p < 0.001) than the non-AKI patients. Cox regression analysis showed that AKI, atrial fibrillation, chronic cardiac insufficiency, longer surgical duration, respiratory failure after surgery, and longer mechanical ventilation time were associated with long-term mortality, while AKI, older age, and lower baseline kidney function were associated with incident CKD stages 3-5.

CONCLUSION

CSA-AKI increased the risk of 3-year mortality and incident CKD stages 3-5.

摘要

背景/目的：评估中国心脏手术相关急性肾损伤（CSA-AKI）患者的长期结局。

方法

纳入接受心脏手术且中位随访时间为 3 年的患者。记录长期生存率和慢性肾脏病（CKD）的发生率，并分析相关危险因素。

结果

在所有 1363 例患者中，457 例（33.5%）发生 CSA-AKI。AKI 患者的 3 年生存率较低（88.8% vs. 97.2%，p < 0.001），CKD 3-5 期的发生率较高（9.9% vs. 2.3%，p < 0.001）。Cox 回归分析显示，AKI、心房颤动、慢性心功能不全、手术时间较长、术后呼吸衰竭以及机械通气时间较长与长期死亡率相关，而 AKI、年龄较大以及基线肾功能较低与 CKD 3-5 期的发生相关。