Wong Chung-Shun, Chen Tzu-Ting, Akhmetzhanov Andrei R, Hu Ping-Jen, Wu Mai-Szu, Wu Mei-Yi
Department of Emergency Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan.
Department of Emergency Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan.
J Clin Med. 2023 Jul 27;12(15):4950. doi: 10.3390/jcm12154950.
Patients with sepsis-associated acute kidney injury (AKI) are at risk of kidney damage, potentially necessitating acute temporary or chronic dialysis. Our study aims to estimate the odds ratio (OR) of preceding sepsis among patients requiring their first dialysis.
A nationwide population-based case-only study was conducted using claims records from the National Health insurance database of Taiwan. All patients over 20 years of age who underwent their first dialysis between 2004 and 2016 were included in the study. The six months prior to their first dialysis served as a self-control period.
The study included 147,201 patients who required acute temporary and 75,031 patients who required chronic dialysis. The odds ratios for patients needing acute temporary dialysis after 1, 2, 3, and 4 weeks of exposure periods were 15.8, 10.7, 9.2, and 8.4, respectively. The ORs for patients requiring chronic dialysis were 7.0, 4.1, 4.2, and 3.7, respectively.
Our findings indicate that sepsis was substantially associated with an increased risk of renal failure. The risk was highest during the first week following sepsis for both acute temporary and chronic dialysis cases.
脓毒症相关急性肾损伤(AKI)患者存在肾脏损害风险,可能需要进行急性临时透析或慢性透析。我们的研究旨在估计首次接受透析治疗的患者先前发生脓毒症的比值比(OR)。
利用台湾国民健康保险数据库的理赔记录进行了一项全国性基于人群的病例对照研究。纳入2004年至2016年间首次接受透析治疗的所有20岁以上患者。首次透析前的六个月作为自身对照期。
该研究纳入了147,201例需要急性临时透析的患者和75,031例需要慢性透析的患者。暴露期1周、2周、3周和4周后需要急性临时透析的患者的比值比分别为15.8、10.7、9.2和8.4。需要慢性透析的患者的OR分别为7.0、4.1、4.2和3.7。
我们的研究结果表明,脓毒症与肾衰竭风险增加密切相关。急性临时透析和慢性透析病例在脓毒症后的第一周风险最高。