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2000 - 2014年美国急性肾损伤住院情况趋势

Trends in Hospitalizations for Acute Kidney Injury - United States, 2000-2014.

作者信息

Pavkov Meda E, Harding Jessica L, Burrows Nilka R

机构信息

Division for Diabetes Translation, CDC.

出版信息

MMWR Morb Mortal Wkly Rep. 2018 Mar 16;67(10):289-293. doi: 10.15585/mmwr.mm6710a2.

Abstract

Acute kidney injury is a sudden decrease in kidney function with or without kidney damage, occurring over a few hours or days. Diabetes, hypertension, and advanced age are primary risk factors for acute kidney injury. It is increasingly recognized as an in-hospital complication of sepsis, heart conditions, and surgery (1,2). Its most severe stage requires treatment with dialysis. Acute kidney injury is also associated with higher likelihood of long-term care, incidence of chronic kidney disease and hospital mortality, and health care costs (1,2). Although a number of U.S. studies have indicated an increasing incidence of dialysis-treated acute kidney injury since the late 1990s (3), no data are available on national trends in diabetes-related acute kidney injury. To estimate diabetes- and nondiabetes-related acute kidney injury trends, CDC analyzed 2000-2014 data from the National Inpatient Sample (NIS) (4) and the National Health Interview Survey (NHIS) (5). Age-standardized rates of acute kidney injury hospitalizations increased by 139% (from 23.1 to 55.3 per 1,000 persons) among adults with diagnosed diabetes, and by 230% (from 3.5 to 11.7 per 1,000 persons) among those without diabetes. Improving both patient and provider awareness that diabetes, hypertension, and advancing age are frequently associated with acute kidney injury might reduce its occurrence and improve management of the underlying diseases in an aging population.

摘要

急性肾损伤是指肾功能突然下降,可伴有或不伴有肾损害,在数小时或数天内发生。糖尿病、高血压和高龄是急性肾损伤的主要危险因素。它越来越被认为是脓毒症、心脏病和手术的院内并发症(1,2)。其最严重阶段需要进行透析治疗。急性肾损伤还与长期护理的可能性增加、慢性肾病的发病率、医院死亡率以及医疗费用相关(1,2)。尽管美国的一些研究表明,自20世纪90年代末以来,接受透析治疗的急性肾损伤发病率有所上升(3),但尚无关于糖尿病相关急性肾损伤全国趋势的数据。为了估计糖尿病相关和非糖尿病相关急性肾损伤的趋势,美国疾病控制与预防中心分析了2000 - 2014年来自全国住院患者样本(NIS)(4)和全国健康访谈调查(NHIS)(5)的数据。在已确诊糖尿病的成年人中,急性肾损伤住院的年龄标准化率上升了139%(从每1000人23.1例增至55.3例),在未患糖尿病的成年人中则上升了230%(从每1000人3.5例增至11.7例)。提高患者和医疗服务提供者对糖尿病、高血压和年龄增长常与急性肾损伤相关的认识,可能会减少急性肾损伤的发生,并改善老年人群潜在疾病的管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/273b/5857198/a02a883612ad/mm6710a2-F1.jpg

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