a Kidney Disease Center , The First Affiliated Hospital, Medical College, Zhejiang University , Hangzhou , PR China.
b Department of Nephrology , Ningbo No. 2 Hospital , Ningbo , PR China.
Ren Fail. 2017 Nov;39(1):736-744. doi: 10.1080/0886022X.2017.1398667.
Acute kidney injury (AKI) is associated with the increased short-term mortality of critically ill patients on continuous renal replacement therapy (CRRT). The aim of this research was to evaluate the association of kidney function at discharge with the long-term renal and overall survival of critically ill patients with AKI who were on CRRT in an intensive care unit (ICU).
We retrospectively collected data for critically ill patients with AKI who were admitted to ICU on CRRT at a tertiary metropolitan hospital in China between 2008 and 2013. The patients were followed up to their death or to 30 September 2016 by telephone.
A total of 403 patients were enrolled in this study. The 1-, 3- and 5-year patient survival rates were 64.3 ± 2.4, 55.8 ± 2.5 and 46.3 ± 2.7%, respectively. In multivariate analysis, age, sepsis, decreased renal perfusion (including volume contraction, congestive heart failure, hypotension and cardiac arrest), preexisting kidney disease, Apache II score, Saps II score, vasopressors and eGFR <45 mL/min/1.73 m at discharge were independent factors for worse long-term patient survival. And age, preexisting kidney disease, Apache II score, mechanical ventilation (MV) and eGFR <45 mL/min/1.73 m at discharge were also associated with worse renal survival.
This study showed that impaired kidney function at discharge was shown to be an important risk factor affecting the long-term renal survival rates of critically ill patients with AKI. An eGFR <45 mL/min/1.73 m was an independent risk factor for decreased overall survival and renal survival.
急性肾损伤（AKI）与接受连续肾脏替代治疗（CRRT）的危重病患者短期死亡率增加有关。本研究旨在评估 ICU 中接受 CRRT 的 AKI 危重病患者出院时的肾功能与长期肾脏和总体生存率的关系。
我们回顾性收集了 2008 年至 2013 年期间在中国一家三级大都市医院 ICU 接受 CRRT 的 AKI 危重病患者的数据。通过电话对患者进行随访，直至死亡或 2016 年 9 月 30 日。
共有 403 例患者纳入本研究。患者的 1、3 和 5 年生存率分别为 64.3±2.4%、55.8±2.5%和 46.3±2.7%。多变量分析显示，年龄、脓毒症、肾灌注减少（包括容量收缩、充血性心力衰竭、低血压和心脏骤停）、原有肾脏疾病、APACHE II 评分、SAPS II 评分、血管加压药和 eGFR＜45ml/min/1.73m 在出院时是长期患者生存率差的独立因素。年龄、原有肾脏疾病、APACHE II 评分、机械通气（MV）和 eGFR＜45ml/min/1.73m 在出院时也与肾脏生存率差相关。
本研究表明，出院时肾功能受损是影响 AKI 危重病患者长期肾脏生存率的重要危险因素。eGFR＜45ml/min/1.73m 是总生存率和肾脏生存率降低的独立危险因素。
