Department of Gastroenterology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, People's Republic of China; Department of Critical Care Medicine, Liaocheng People's Hospital, Liaocheng, Shandong, 252000, People's Republic of China.
Center of Severe Acute Pancreatitis (CSAP), Department of Critical Care Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, 210002, People's Republic of China.
HPB (Oxford). 2022 Feb;24(2):169-175. doi: 10.1016/j.hpb.2021.05.012. Epub 2021 Jun 7.
To evaluate the event rate of major adverse kidney events within 30 days (MAKE30) in acute pancreatitis (AP) and its potential risk factors.
A retrospective analysis of a tertiary center data on all AP patients admitted within 72 h after onset of abdominal pain between June 2015 and June 2019 was conducted. MAKE30 - a composite of death, new renal replacement therapy (RRT), or persistent renal dysfunction (PRD) - and its individual components were retrieved at discharge or 30 days. Logistic regression analysis was used to assess the risk factors for MAKE30.
295 patients were enrolled and 16% experienced MAKE30. For individual components, the incidence was 3% for death, 15% for new RRT, and 5% for PRD. In multivariate logistic regression analysis, hyperchloremia at admission [OR = 8.38 (1.07-65.64); P = 0.043] and SOFA score [OR 1.63 (1.18-2.26); P = 0.003] were independent risk factors in predicting MAKE30. Further analysis showed that patients with hyperchloremia had more requirements of RRT (57% vs. 10%, P < 0.001), more PRD (14% vs. 4%, P = 0.034).
MAKE30 is a common event in AP patients. Hyperchloremia and SOFA score at admission were two independent risk factors for MAKE30.
评估 30 天内（MAKE30）急性胰腺炎（AP）主要不良肾脏事件的发生率及其潜在危险因素。
对 2015 年 6 月至 2019 年 6 月期间发病后 72 小时内入住的所有 AP 患者的三级中心数据进行回顾性分析。MAKE30 - 死亡、新肾脏替代治疗（RRT）或持续肾功能障碍（PRD）的综合指标 - 及其各个组成部分在出院或 30 天时进行检索。采用逻辑回归分析评估 MAKE30 的危险因素。
共纳入 295 例患者，16%的患者发生 MAKE30。对于个别成分，死亡率为 3%，新 RRT 为 15%，PRD 为 5%。多变量逻辑回归分析显示，入院时高氯血症[比值比（OR）= 8.38（1.07-65.64）；P = 0.043]和 SOFA 评分[OR 1.63（1.18-2.26）；P = 0.003]是预测 MAKE30 的独立危险因素。进一步分析显示，高氯血症患者对 RRT 的需求更多（57%比 10%，P <0.001），PRD 更多（14%比 4%，P = 0.034）。
MAKE30 是 AP 患者常见的事件。入院时高氯血症和 SOFA 评分是 MAKE30 的两个独立危险因素。
