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急性肾损伤的病因谱与不良结局:一项单中心观察研究

Etiological spectrum of acute kidney injury and adverse outcome: A single-center observation.

作者信息

Rout Nikunj Kishore, Choudhury Arpita Ray, Dasgupta Sanjay, Pathi Debasis, Panda Bandita, Pandey Rajendra

机构信息

Department of Nephrology, Kalinga Institute of Medical Science, KIIT DU, Bhubaneswar, Odisha, India.

Department of Nephrology, Institute of Post Graduate Medical Education and Research, Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India.

出版信息

J Family Med Prim Care. 2024 Oct;13(10):4371-4376. doi: 10.4103/jfmpc.jfmpc_366_24. Epub 2024 Oct 18.

Abstract

BACKGROUND

The present study aims to evaluate the etiological spectrum with clinicopathological parameters and adverse outcomes of acute kidney injury (AKI).

METHODS

A hospital-based prospective observational study was conducted for a spectrum of AKI in 103 AKI patients and their AKI-associated adverse outcomes. The AKI patients were included as per the KDIGO definition. The patients with a known chronic kidney disease (CKD) were excluded from the study population. A clinicopathological association with AKI was observed. Adverse outcomes and the need for renal biopsy were recorded in 3 weeks followed up to 6 months.

RESULTS

A single-center study recorded that the incidence of AKI was 8.6% with a mean age of 34 ± 16 years. The cause of AKI due to medical reasons was maximum (70.8%), followed by obstetric (21.3%) and surgery (7.7%). The AKI mortality rate was 16% ( < 0.05). Renal biopsy in 34 cases showed that acute tubular necrosis was higher (38%), followed by acute cortical necrosis (23%). The spectrum of AKI was very diverse. In the 6-month follow-up, the adverse outcome was observed in 27.2% of patients, where the mortality rate was 16.5% and 10.7% of patients progressed to CKD.

CONCLUSION

The spectrum of AKI was diverse among the population, and most of the etiologies are preventable. This alarms the need for better preventive strategies with a better referral system. The obstetric population with AKI, which majorly leads to either mortality or progression to CKD, is the section that seeks more attention.

摘要

背景

本研究旨在评估急性肾损伤(AKI)的病因谱及其临床病理参数和不良结局。

方法

开展了一项基于医院的前瞻性观察性研究,纳入103例AKI患者,观察其AKI谱及相关不良结局。AKI患者根据KDIGO定义纳入。已知患有慢性肾脏病(CKD)的患者被排除在研究人群之外。观察AKI的临床病理关联。在3周随访至6个月期间记录不良结局及肾活检需求。

结果

一项单中心研究记录显示,AKI发病率为8.6%,平均年龄为34±16岁。因医疗原因导致的AKI最多(70.8%),其次是产科原因(21.3%)和手术原因(7.7%)。AKI死亡率为16%(P<0.05)。34例肾活检显示急性肾小管坏死比例较高(38%),其次是急性皮质坏死(23%)。AKI谱非常多样。在6个月的随访中,27.2%的患者出现不良结局,其中死亡率为16.5%,10.7%的患者进展为CKD。

结论

AKI谱在人群中多样,且大多数病因是可预防的。这警示需要通过更好的转诊系统制定更好的预防策略。产科AKI人群主要导致死亡或进展为CKD,是需要更多关注的群体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/369f/11610883/506ab7273e88/JFMPC-13-4371-g001.jpg

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