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肾病科病房急性肾损伤的治疗结果

Outcomes of acute kidney injury in a nephrology ward.

作者信息

Fernandes Ana R, Viegas Márcio S R, Soares Elsa Q, Coelho Sofia S, Valério Patricia, Barreto José C, Vinhas José M

机构信息

Serviço de Nefrologia do Centro Hospitalar de Setúbal, Setúbal, Portugal.

出版信息

Int Urol Nephrol. 2017 Dec;49(12):2185-2193. doi: 10.1007/s11255-017-1716-6. Epub 2017 Oct 11.

Abstract

Acute kidney injury (AKI) is a global problem which predicts immediate and long-term adverse outcomes. We evaluated the AKI progression to end-stage renal disease, as well as the mortality associated with AKI and the in-hospital readmission rate because of a cardiovascular event in AKI patients admitted in a nephrology ward. A 5-year retrospective study was set in a nephrology department, with a follow-up period of up to 8 years. In a total of 191 patients, mean age was 73.83 ± 12.49 years, and 137 (71.7%) patients had history of chronic kidney disease. One hundred and twenty-four (65%) patients needed RRT and two (1%) needed surgery. Upon discharge, 107 (56%) patients had recovered the renal function, 41 (21.6%) patients had partial recovery, 25 (13%) patients were RRT dependent, 16 (8.4%) died, and two (1%) patients had outcomes unknown to us, because they were transferred to other hospitals. The median survival time free of RRT was 74 months. The median survival time of the followed patients was 34 months (95% CI 23.3-44.7). The mortality rate in the follow-up period in this sample was 18 deaths/100 patients-years, and the incidence of a composite cardiovascular endpoint of heart failure, acute coronary syndrome, and stroke was 6 events/100 patients-years. The mortality rate in the follow-up period was higher than usually described for patients outside intensive care unit, probably because our patients were old and had many comorbidities.

摘要

急性肾损伤(AKI)是一个全球性问题,它预示着近期和长期的不良后果。我们评估了AKI进展至终末期肾病的情况,以及与AKI相关的死亡率和因心血管事件导致的AKI患者的院内再入院率。在一个肾脏病科进行了一项为期5年的回顾性研究,随访期长达8年。总共191例患者,平均年龄为73.83±12.49岁,137例(71.7%)患者有慢性肾脏病病史。124例(65%)患者需要肾脏替代治疗(RRT),2例(1%)患者需要手术。出院时,107例(56%)患者肾功能恢复,41例(21.6%)患者部分恢复,25例(13%)患者依赖RRT,16例(8.4%)死亡,2例(1%)患者结局不明,因为他们被转至其他医院。无RRT的中位生存时间为74个月。随访患者的中位生存时间为34个月(95%CI 23.3 - 44.7)。该样本随访期的死亡率为18例死亡/100患者-年,心力衰竭、急性冠状动脉综合征和中风的复合心血管终点事件发生率为6例事件/100患者-年。随访期的死亡率高于通常报道的非重症监护病房患者,可能是因为我们的患者年龄较大且有许多合并症。

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