Department of Internal Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Korea.
Medical Research Collaborating Center, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Korea.
Sci Rep. 2019 Feb 26;9(1):2798. doi: 10.1038/s41598-019-38892-1.
Although low serum bicarbonate level is known to be associated with adverse outcomes in patients with chronic kidney injury, it is unclear whether low serum bicarbonate level is associated with the development of acute kidney injury (AKI). The purpose of our study was to determine whether serum bicarbonate levels at admission could be a risk factor for AKI development and mortality in hospitalised patients. We retrospectively enrolled 17,320 adult patients who were admitted to the academic teaching hospital from January 2013 to December 2013. Patients were divided into 2 groups based on the first measurement of serum bicarbonate level at admission. The incidence of AKI was higher in patients with low serum bicarbonate level than in those with normal serum bicarbonate level (8.0% vs. 4.1%). Low serum bicarbonate levels at admission were significantly associated with the development of AKI. In addition, low serum bicarbonate levels also independently predicted the 90-day mortality. Pre-existing low bicarbonate levels and subsequent development of AKI increased in-hospital mortality by 15 times compared with that in patients with normal bicarbonate levels and no AKI. Low serum bicarbonate levels may be associated with the development of AKI and high mortality in hospitalised patients.
虽然低血清碳酸氢盐水平与慢性肾损伤患者的不良预后相关，但低血清碳酸氢盐水平是否与急性肾损伤（AKI）的发生相关尚不清楚。本研究旨在确定入院时的血清碳酸氢盐水平是否可作为住院患者发生 AKI 及死亡的危险因素。我们回顾性纳入了 2013 年 1 月至 2013 年 12 月在学术教学医院就诊的 17320 例成年患者。根据入院时首次测量的血清碳酸氢盐水平将患者分为 2 组。低血清碳酸氢盐组患者的 AKI 发生率高于正常血清碳酸氢盐组（8.0% vs. 4.1%）。入院时低血清碳酸氢盐水平与 AKI 的发生显著相关。此外，低血清碳酸氢盐水平还独立预测了 90 天死亡率。与正常碳酸氢盐水平且无 AKI 的患者相比，预先存在的低碳酸氢盐水平和随后发生 AKI 使住院死亡率增加了 15 倍。低血清碳酸氢盐水平可能与住院患者 AKI 的发生和高死亡率相关。
