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急性肾损伤后慢性肾脏病进展的危险因素。

Risk factors for the progression of chronic kidney disease after acute kidney injury.

作者信息

Pereira Benedito Jorge, Barreto Silvana, Gentil Thais, Assis Larissa S, Soeiro Emília Md, Castro Isac de, Laranja Sandra M

机构信息

Universidade Nove de Julho.

Hospital do Servidor Público Estadual de São Paulo.

出版信息

J Bras Nefrol. 2017 Jul-Sep;39(3):239-245. doi: 10.5935/0101-2800.20170041. Epub 2017 Aug 28.

Abstract

INTRODUCTION

The incidence of chronic kidney disease (CKD) is increasing with the increasing age of the population and the increasing number of elderly survivors of acute kidney injury (AKI). The risk factors for the progression of CKD after AKI are unclear.

OBJECTIVE

To investigate the association between AKI and its progression to CKD and the risk factors involved.

METHODS

An observational, retrospective study of AKI patients followed from 2009 to 2012 was carried out. We evaluated the etiology of AKI, the use of vasoactive drugs and mechanical ventilation, the need for dialysis, the presence of comorbidities, the glomerular filtration rate (GFR), the length of stay and the progression of CKD. Statistical analyses, including the Chi-square test and Pearson's correlation, were performed using SPSS.

RESULTS

The 207 patients analyzed had a mean age of 70.1 ± 13.1, and 84.6% of the male patients exhibited decreased renal function and CKD (vs. 60.4% of the female patients). The progression of AKI to CKD was more frequent in patients admitted to wards (63.8%), cancer patients (74.19%), patients with sepsis (67.18%) and patients with obstruction (91.66%). Dialyses were performed in 16.4% of the patients, but this was not correlated with the progression of CKD.

CONCLUSIONS

Being an elderly male patient with AKI due to sepsis and obstruction was correlated with progression to CKD following discharge.

摘要

引言

随着人口老龄化以及急性肾损伤(AKI)老年幸存者数量的增加,慢性肾脏病(CKD)的发病率正在上升。AKI后CKD进展的危险因素尚不清楚。

目的

探讨AKI与其进展为CKD之间的关联以及相关危险因素。

方法

对2009年至2012年随访的AKI患者进行了一项观察性回顾性研究。我们评估了AKI的病因、血管活性药物和机械通气的使用情况、透析需求、合并症的存在、肾小球滤过率(GFR)、住院时间以及CKD的进展情况。使用SPSS进行了包括卡方检验和Pearson相关性分析在内的统计分析。

结果

分析的207例患者平均年龄为70.1±13.1岁,84.6%的男性患者肾功能下降并患有CKD(女性患者为60.4%)。在病房住院的患者(63.8%)、癌症患者(74.19%)、脓毒症患者(67.18%)和梗阻患者(91.66%)中,AKI进展为CKD的情况更为常见。16.4%的患者进行了透析,但这与CKD的进展无关。

结论

因脓毒症和梗阻导致AKI的老年男性患者出院后进展为CKD有关。

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