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对比剂诱导的急性肾损伤:重症监护病房中确立患病率和预后的诊断标准的重要性

Contrast-induced acute kidney injury: the importance of diagnostic criteria for establishing prevalence and prognosis in the intensive care unit.

作者信息

Moura Edmilson Leal Bastos de, Amorim Fábio Ferreira, Huang William, Maia Marcelo de Oliveira

机构信息

Unidade de Terapia Intensiva, Hospital Santa Luzia - Brasília (DF), Brasil.

Escola Superior de Ciências da Saúde - Brasília (DF), Brasil.

出版信息

Rev Bras Ter Intensiva. 2017 Jul-Sep;29(3):303-309. doi: 10.5935/0103-507X.20170041. Epub 2017 Sep 4.

Abstract

OBJECTIVE

To establish whether there is superiority between contrast-induced acute kidney injury and contrast-induced nephropathy criteria as predictors of unfavorable clinical outcomes.

METHODS

Retrospective study carried out in a tertiary hospital with 157 patients undergoing radiocontrast infusion for propaedeutic purposes.

RESULTS

One hundred forty patients fulfilled the inclusion criteria: patients who met the criteria for contrast-induced acute kidney injury (59) also met the criteria for contrast-induced nephropathy (76), 44.3% met the criteria for KDIGO staging, 6.4% of the patients required renal replacement therapy, and 10.7% died.

CONCLUSION

The diagnosis of contrast-induced nephropathy was the most sensitive criterion for renal replacement therapy and death, whereas KDIGO showed the highest specificity; there was no correlation between contrast volume and progression to contrast-induced acute kidney injury, contrast-induced nephropathy, support dialysis or death in the assessed population.

摘要

目的

确定对比剂诱导的急性肾损伤和对比剂肾病标准作为不良临床结局预测指标时是否存在优越性。

方法

在一家三级医院开展回顾性研究,纳入157例因诊断目的接受放射性对比剂输注的患者。

结果

140例患者符合纳入标准:符合对比剂诱导的急性肾损伤标准的患者(59例)也符合对比剂肾病标准(76例),44.3%符合KDIGO分期标准,6.4%的患者需要肾脏替代治疗,10.7%死亡。

结论

对比剂肾病的诊断是肾脏替代治疗和死亡最敏感的标准,而KDIGO标准特异性最高;在评估人群中,对比剂用量与进展为对比剂诱导的急性肾损伤、对比剂肾病、支持性透析或死亡之间无相关性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3777/5632972/532786253ab9/rbti-29-03-0303-g01.jpg

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