Asmus K, Erfurt S, Ritter O, Patschan S, Patschan D
Zentrum für Innere Medizin 1, Kardiologie, Angiologie, Nephrologie, Klinikum Brandenburg, Medizinische Hochschule Brandenburg, Brandenburg, Germany.
Int J Nephrol. 2021 Apr 26;2021:5549316. doi: 10.1155/2021/5549316. eCollection 2021.
Acute kidney injury substantially worsens the prognosis of hospitalized patients. The Brandenburg Medical School was founded in 2014, and a nephrology section was opened in summer 2017. The aim of the study was to analyze AKI epidemiology and outcomes in one of two university hospitals belonging to the medical school. The period of interest dated from January to December 2015.
The investigation was designed as a single-center, retrospective cohort study at the Brandenburg Hospital of the Brandenburg Medical School. All in-hospital patients treated between January and the end of December 2015 were included. AKI was defined as specified in the 2012 published KDIGO criteria (criteria 1 and 2). Four parameters were evaluated in particular: AKI incidence, in-hospital mortality, frequency of renal replacement therapy, and renal recovery during the stay at the hospital.
A total number of 5,300 patients were included in the analysis. AKI was diagnosed in 490 subjects (10.1%). The in-hospital mortality was 26%. The following conditions/parameters significantly differed between survivors (s) and nonsurviving (ns) subjects: duration of in-hospital treatment (s > ns), AKI onset (outpatient vs. in-hospital) (outpatient in s > ns), dialysis due to AKI (s < ns), vasopressor administration ( < ns), and invasive ventilation (s < ns). 5.6% received dialysis therapy, and renal recovery occurred in 31% of all surviving AKI subjects.
Both, the AKI incidence and the frequency of dialysis were lower than reported in the literature. However, fewer subjects recovered from AKI. These discrepant findings possibly result from the lack of prehospitalization creatinine values, the lack of follow-up data, and a generally lower awareness for the need to perform renal replacement therapy in AKI.
急性肾损伤会显著恶化住院患者的预后。勃兰登堡医学院于2014年成立，并于2017年夏季开设了肾脏病科。本研究的目的是分析该医学院所属两家大学医院之一的急性肾损伤的流行病学及转归情况。研究时间段为2015年1月至12月。
该调查设计为在勃兰登堡医学院勃兰登堡医院进行的一项单中心回顾性队列研究。纳入了2015年1月至12月底期间所有住院治疗的患者。急性肾损伤的定义按照2012年发布的KDIGO标准（标准1和2）。特别评估了四个参数：急性肾损伤发生率、住院死亡率、肾脏替代治疗频率以及住院期间的肾功能恢复情况。
共有5300例患者纳入分析。490例受试者（10.1%）被诊断为急性肾损伤。住院死亡率为26%。存活者（s）和非存活者（ns）在以下情况/参数上存在显著差异：住院治疗时长（s＞ns）、急性肾损伤发病情况（门诊 vs. 住院）（s中门诊发病者＞ns）、因急性肾损伤进行透析（s＜ns）、血管活性药物使用情况（s＜ns）以及有创通气情况（s＜ns）。5.6%的患者接受了透析治疗，所有存活的急性肾损伤受试者中有31%肾功能恢复。
急性肾损伤发生率和透析频率均低于文献报道。然而，急性肾损伤恢复的患者较少。这些差异可能是由于缺乏院前肌酐值、缺乏随访数据以及对急性肾损伤进行肾脏替代治疗必要性的总体认识较低所致。
