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多项血气变量可独立预测 AKI 患者的生存情况。

Multiple blood gas variables predict AKI survival in an independent manner.

机构信息

Department of Internal Medicine I - Cardiology, Nephrology and Internal Intensive Care Medicine Brandenburg University Hospital, Brandenburg Medical School (Theodor Fontane), Hochstraße 29, 14770, Brandenburg an der Havel, Germany.

Faculty of Health Sciences (FGW), joint faculty of the University of Potsdam, the Brandenburg Medical School Theodor Fontane and the Brandenburg Technical University Cottbus-Senftenberg, Brandenburg an der Havel, Germany.

出版信息

BMC Nephrol. 2024 Jan 23;25(1):28. doi: 10.1186/s12882-024-03470-9.

Abstract

BACKGROUND AND AIM

Acute kidney injury (AKI) is becoming increasingly prevalent among hospitalized patients and carries a poor prognosis. While new biomarkers show promise in identifying early stages of AKI, accurately predicting severe outcomes such as the need for kidney replacement therapy (KRT) or death remains a challenge. However, blood gas analyses (BGA) can be used to diagnose life-threatening complications associated with AKI. The objective of this study was to assess the role of BGA as a biomarker panel in both emerging and established cases of AKI.

METHODS

Retrospective observational study examining subjects with newly developed acute kidney injury (AKI). The study will document venous and arterial pH, pCO2, and actual bicarbonate levels upon hospital admission and at the onset of AKI. The primary endpoints include in-hospital mortality, the need for kidney replacement therapy (KRT), and the recovery of kidney function (ROKF).

RESULTS

A total of 202 individuals were included in the study. Three variables were found to be independent predictors of in-hospital survival: admission arterial pH, arterial pH at acute kidney injury (AKI) onset, and arterial pCO2 at AKI onset. Additionally, venous pCO2 at AKI onset was identified as an independent predictor for the need of kidney replacement therapy (KRT).

CONCLUSIONS

Our study suggests that blood gas analysis may have a potential role in predicting severe outcome variables in acute kidney injury (AKI). The associated costs are minimal.

摘要

背景与目的

急性肾损伤(AKI)在住院患者中越来越普遍,预后较差。虽然新的生物标志物在识别 AKI 的早期阶段显示出希望,但准确预测严重结局,如需要肾脏替代治疗(KRT)或死亡,仍然是一个挑战。然而,血气分析(BGA)可用于诊断与 AKI 相关的危及生命的并发症。本研究旨在评估 BGA 作为新兴和已确立的 AKI 生物标志物组合的作用。

方法

回顾性观察性研究,检查新发生的急性肾损伤(AKI)患者。本研究将记录入院时和 AKI 发作时的静脉和动脉 pH、pCO2 和实际碳酸氢盐水平。主要终点包括院内死亡率、需要肾脏替代治疗(KRT)和肾功能恢复(ROKF)。

结果

共有 202 人纳入研究。有 3 个变量被发现是院内生存的独立预测因素:入院时动脉 pH、AKI 发作时动脉 pH 和 AKI 发作时动脉 pCO2。此外,AKI 发作时的静脉 pCO2 被确定为需要肾脏替代治疗(KRT)的独立预测因素。

结论

我们的研究表明,血气分析可能在预测急性肾损伤(AKI)的严重结局变量方面具有潜在作用。相关成本微不足道。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/71b4/10804712/15143c7f0dd6/12882_2024_3470_Fig1_HTML.jpg

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