Service de Néphrologie, CHU Hôpital Pontchaillou, 2 rue Henri Le Guilloux, 35033, Rennes Cedex, France.
Centre Hospitalier Public du Cotentin, Service de Néphrologie, Rue Trottebec, BP 208, 50102, Cherbourg Octeville Cedex, France.
J Nephrol. 2021 Oct;34(5):1501-1509. doi: 10.1007/s40620-020-00953-4. Epub 2021 Mar 25.
Acute renal infarction is a rare occurence, whose prognosis and long-term outcomes remain poorly studied. This study evaluated whether clinical and radiological features at diagnosis can be associated with the long-term outcomes (blood pressure, kidney function and mortality).
We retrospectively analyzed the demographic, clinical, biological and radiological data of patients with acute renal infarction hospitalized at Rennes University Hospital between 1997 and 2017 (n = 94).
Patients were followed-up for a median of 60 months. At time of diagnosis of acute renal infarction median age was 53 years, 45% of the patients had acute hypertension, and 31% had Acute Kidney Injury (AKI) requiring dialysis in seven patients. The median Lactate DeHydrogenase (LDH) level was 977 IU/mL. The median extent of kidney damage was 14%, with left renal involvement in 51% of patients. At 60 months of follow-up, 66% of patients had developed Chronic Kidney Disease (CKD) stage 3 or higher, and 55% had hypertension since diagnosis. Age, acute development of hypertension and AKI at diagnosis were associated with long-term CKD (stage 3 or higher) in multivariate analyses, but the extent of kidney damage was not. During the follow-up, 21% of patients died, and only age resulted as a predisposing factor. No tested factor was correlated with long-term hypertension.
Age, acute development of hypertension, and AKI were correlated with long term CKD, whereas no factor was correlated with long-term hypertension after acute renal infarction.
急性肾梗死是一种罕见的疾病，其预后和长期结局仍研究甚少。本研究评估了诊断时的临床和影像学特征是否与长期结局（血压、肾功能和死亡率）相关。
我们回顾性分析了 1997 年至 2017 年期间在雷恩大学医院住院的急性肾梗死患者的人口统计学、临床、生物学和影像学资料（n=94）。
患者中位随访时间为 60 个月。在急性肾梗死诊断时，中位年龄为 53 岁，45%的患者有急性高血压，31%的患者有急性肾损伤（AKI），7 例患者需要透析。中位乳酸脱氢酶（LDH）水平为 977IU/ml。肾脏损伤的中位数为 14%，51%的患者左肾受累。60 个月随访时，66%的患者发展为慢性肾脏病（CKD）3 期或更高，55%的患者自诊断以来存在高血压。年龄、急性高血压和 AKI 的发生与多变量分析中的长期 CKD（3 期或更高）相关，但肾脏损伤的程度无关。在随访期间，21%的患者死亡，只有年龄是一个诱发因素。没有测试的因素与急性肾梗死后的长期高血压相关。
年龄、急性高血压的发生和 AKI 与长期 CKD 相关，而急性肾梗死后没有任何因素与长期高血压相关。
