三级保健中心与急性肠胃炎相关的急性肾损伤。
Acute gastroenteritis-related acute kidney injury in a tertiary care center.
机构信息
From the College of Medicine, King Saud Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
From the Department of Infectious Diseases, King Abdulaziz Medical City, Jeddah, Saudi Arabia.
出版信息
Ann Saudi Med. 2023 Mar-Apr;43(2):82-89. doi: 10.5144/0256-4947.2023.82. Epub 2023 Apr 6.
BACKGROUND
Acute gastroenteritis (AGE) can cause acute kidney injury (AKI) via hypoperfusion mechanisms. Early detection of AKI caused by AGE can significantly decrease mortality rates. In Saudi Arabia, studies investigating the association between AGE and AKI are limited; thus, we aimed to fill this knowledge gap.
OBJECTIVES
Analyze all cases of AGE reported in tertiary-care hospitals to assess the prevalence of AKI among AGE patients.
DESIGN
Retrospective cohort SETTINGS: Single tertiary-care center PATIENTS AND METHODS: The study included patients treated for AGE between October 2017 and October 2022. Stool culture was used to diagnose AGE. Inclusion criteria were infective diarrhea and/ or vomiting, and availability of data (demographics, comorbidities, malignancies, length of hospital stay, vital signs at the time of diagnosis, dehydration, causative agents of diarrhea, hemodialysis status, and laboratory data.
MAIN OUTCOME MEASURES
Prevalence of AKI among AGE patients and factors associated with development of AKI.
SAMPLE SIZE
300 patients diagnosed with AGE.
RESULTS
Of the 300 patients with AGE, 41 (13.6%) had AKI, those older than 60 years were more likely to develop AKI. The most frequent cause of AGE was . (n=163, 53.3%), whereas AKI was most common in AGE patients (n=21, 51.2%). Furthermore, the most common comorbidity in the present study was malignancy, especially leukemia and lymphoma the risk of AKI was independently associated with mild dehydration, higher serum urea concentrations and low GFR values.
CONCLUSIONS
Patients hospitalized for diarrheal disease are at an increased risk of developing AKI due to dehydration and comorbid conditions. It is crucial to keep kidney function in mind for AGE patients as this is associated with a high mortality rate and poor prognosis.
LIMITATIONS
The main limitation of this study was its retrospective design. Another limitation is that it is limited to a single center.
CONFLICTS OF INTEREST
None.
背景
急性肠胃炎（AGE）可通过低灌注机制导致急性肾损伤（AKI）。早期发现 AGE 引起的 AKI 可显著降低死亡率。在沙特阿拉伯，研究 AGE 与 AKI 之间关系的研究有限；因此，我们旨在填补这一知识空白。
目的
分析三级保健医院报告的所有 AGE 病例，以评估 AGE 患者中 AKI 的患病率。
设计
回顾性队列
设置
单一三级保健中心
患者和方法
本研究纳入 2017 年 10 月至 2022 年 10 月期间因 AGE 接受治疗的患者。粪便培养用于诊断 AGE。纳入标准为感染性腹泻和/或呕吐，以及数据（人口统计学、合并症、恶性肿瘤、住院时间、诊断时的生命体征、脱水、腹泻的病原体、血液透析状态和实验室数据）可用。
主要观察指标
AGE 患者中 AKI 的患病率以及与 AKI 发生相关的因素。
样本量
300 例诊断为 AGE 的患者。
结果
在 300 例 AGE 患者中，41 例（13.6%）患有 AKI，年龄大于 60 岁的患者更有可能发生 AKI。AGE 最常见的病因是（n=163，53.3%），而 AKI 最常见于（n=21，51.2%）。此外，本研究中最常见的合并症是恶性肿瘤，特别是白血病和淋巴瘤。AKI 的风险与轻度脱水、血清尿素浓度升高和肾小球滤过率降低独立相关。
结论
因脱水和合并症住院的腹泻病患者发生 AKI 的风险增加。考虑到 AGE 患者的肾功能，这与高死亡率和预后不良有关。
局限性
本研究的主要局限性是回顾性设计。另一个限制是它仅限于一个中心。
利益冲突
无。
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