Wang Peng, Yang Jianbo, Zhang Yupeng, Zhang Li, Gao Xuejin, Wang Xinying
Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
Department of General Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
Front Nutr. 2021 Jan 18;7:618758. doi: 10.3389/fnut.2020.618758. eCollection 2020.
Renal impairment is a common complication in patients with intestinal failure that is mostly caused by short bowel syndrome (SBS) and is associated with adverse outcomes that severely affect the quality of life or even survival. The prevalence and risk factors for renal impairment in patients with SBS remain unclarified. Therefore, we aimed to determine the prevalence of renal impairment and identify potential risk factors for renal impairment in adult patients with SBS. We retrospectively identified 199 patients diagnosed with SBS admitted to the Department of General Surgery between January 1, 2012 and January 1, 2019, from a prospectively maintained database. Overall, 56 patients (28.1%) with decreased renal function (eGFR < 90 mL/min/1.73 m). The median duration of SBS was 7 months (IQR, 3-31 months) and the mean eGFR was 103.1 ± 39.4 mL/min/1.73 m. Logistic regression modeling indicated that older age [odds ratio (OR), 1.074; 95% CI, 1.037-1.112, < 0.001], kidney stones (OR, 4.887; 95% CI, 1.753-13.626; = 0.002), decreased length of the small intestine (OR, 0.988; 95% CI, 0.979-0.998; = 0.019), and prolonged duration of SBS (OR, 1.007; 95% CI, 1.001-1.013; = 0.046) were significant risk factors for renal impairment. This is the largest study that has specifically explored the risk factors for renal impairment in a large cohort of adults with SBS. The present study showed that renal function should be closely monitored during treatment, and patients should be given prophylactic interventions if necessary. This retrospective study is a part of clinical study NCT03277014, registered in ClinicalTrials.gov PRS. And the PRS URL is http://register.clinicaltrials.gov.
肾功能损害是肠衰竭患者的常见并发症,主要由短肠综合征(SBS)引起,并与严重影响生活质量甚至生存的不良后果相关。SBS患者肾功能损害的患病率和危险因素仍不明确。因此,我们旨在确定成年SBS患者肾功能损害的患病率,并识别肾功能损害的潜在危险因素。我们从一个前瞻性维护的数据库中回顾性识别出2012年1月1日至2019年1月1日期间入住普通外科的199例诊断为SBS的患者。总体而言,56例患者(28.1%)肾功能下降(估算肾小球滤过率[eGFR]<90 mL/min/1.73 m²)。SBS的中位病程为7个月(四分位间距,3 - 31个月),平均eGFR为103.1±39.4 mL/min/1.73 m²。逻辑回归模型表明,年龄较大[比值比(OR),1.074;95%置信区间(CI),1.037 - 1.112,P<0.001]、肾结石(OR,4.887;95% CI,1.753 - 13.626;P = 0.002)、小肠长度缩短(OR,0.988;95% CI,0.979 - 0.998;P = 0.019)以及SBS病程延长(OR,1.007;95% CI,1.001 - 1.013;P = 0.046)是肾功能损害的显著危险因素。这是专门探讨一大群成年SBS患者肾功能损害危险因素的最大规模研究。本研究表明,治疗期间应密切监测肾功能,必要时应对患者进行预防性干预。这项回顾性研究是临床研究NCT03277014的一部分,该研究已在ClinicalTrials.gov上注册。PRS网址为http://register.clinicaltrials.gov 。