Nephrology Division, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Kidney Transplant Unit, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
BMC Nephrol. 2019 Aug 13;20(1):315. doi: 10.1186/s12882-019-1514-8.
Performing a kidney biopsy is necessary to accurately diagnose diseases such as glomerulonephritis and tubulointerstitial nephritis, among other such conditions. These conditions predispose patients to chronic kidney disease, as well as acute kidney injury (AKI). Notably, most epidemiological studies describing AKI have not investigated this patient population.
Included patients admitted to the nephrology ward of a tertiary hospital who underwent percutaneous kidney biopsy. AKI was diagnosed based on the Kidney Disease: Improving Global Outcomes criteria.
Of the 223 patients investigated, 140 (62.8%) showed AKI. Of these, 91 (65%), 19 (13.6%), and 30 (21.4%) presented with AKI classified as stages 1, 2, and 3, respectively. The primary indication for performing biopsy was nephrotic syndrome or nephrotic proteinuria (73 [52.1%] in the AKI vs. 51 [61.4%] in the non-AKI group, p = 0.048). Focal segmental glomerulosclerosis was the most prevalent primary disease (24 [17.1%] in the AKI vs. 15 [18.0%] in the non-AKI group, p = 0.150). Multivariate analysis of risk factors associated with AKI showed hemoglobin levels (odds ratio [OR] 0.805, 95% confidence interval [CI] 0.681-0.951, p = 0.011), serum high-density lipoprotein cholesterol levels (HDL-c, OR 0.970, 95% CI 0.949-0.992, p = 0.008), and baseline serum creatinine levels (OR 2.703, 95% CI 1.471-4.968, p = 0.001) were significantly associated with AKI.
We observed a high prevalence of AKI in hospitalized patients who underwent kidney biopsy to investigate their renal disease, particularly glomerulonephritis. Higher levels of hemoglobin and serum HDL-c were associated with a lower risk of AKI.
为了准确诊断肾小球肾炎和肾小管间质性肾炎等疾病，有必要进行肾脏活检。这些疾病会导致患者发生慢性肾脏病和急性肾损伤（AKI）。值得注意的是，大多数描述 AKI 的流行病学研究并未调查该患者人群。
纳入在一家三级医院肾内科病房住院并接受经皮肾活检的患者。根据改善全球肾脏病预后组织（KDIGO）标准诊断 AKI。
在 223 名接受调查的患者中，140 名（62.8%）出现 AKI。其中，91 名（65%）、19 名（13.6%）和 30 名（21.4%）分别为 AKI 1 期、2 期和 3 期。进行活检的主要指征是肾病综合征或肾病性蛋白尿（AKI 组 73 例[52.1%]，非 AKI 组 51 例[61.4%]，p=0.048）。局灶节段性肾小球硬化症是最常见的原发性疾病（AKI 组 24 例[17.1%]，非 AKI 组 15 例[18.0%]，p=0.150）。AKI 相关危险因素的多变量分析显示，血红蛋白水平（比值比[OR] 0.805，95%置信区间[CI] 0.681-0.951，p=0.011）、血清高密度脂蛋白胆固醇水平（HDL-c，OR 0.970，95%CI 0.949-0.992，p=0.008）和基线血清肌酐水平（OR 2.703，95%CI 1.471-4.968，p=0.001）与 AKI 显著相关。
我们观察到在接受肾脏活检以调查其肾脏疾病的住院患者中，AKI 的患病率较高，尤其是肾小球肾炎。较高的血红蛋白和血清 HDL-c 水平与 AKI 风险降低相关。
