Han Lina, Li Hongxiao, Luo Lingfan, Ye Xiaolan, Ren Yan, Xu Zimeng, Zhang Wei, Zhang Jiawei, Li Yiwen, Chen Bin, Zhu Bin, Shao Lina
Kidney Department, Zhenhai People's Hospital (Ningbo No.7 Hospital), 718 Nanerxi Road, Luotuo Subdistrict, Zhenhai, Ningbo, China.
Urology and Nephrology Center, Department of Nephrology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China.
Sci Rep. 2025 Feb 21;15(1):6305. doi: 10.1038/s41598-025-88732-8.
Acute kidney injury (AKI) is a frequent yet often overlooked complication. This study examines the incidence, unrecognized rate, and outcomes of AKI in adults at a large public Chinese hospital from 2010 to 2023. AKI rates were calculated, and outcomes were assessed using follow-up records. Multivariate logistic regression identified risk factors for unrecognized AKI. Among 2,790,540 patients, 5,080 met the AKI criteria, with an overall incidence of 0.18% (0.78% in hospitalizations, 0.05% in outpatients). The unrecognized AKI was 76.3%. In this group, 75% were stage 1, 16.7% stage 2, and 8.3% stage 3. Orthopedics had the highest unrecognized rate (94.5%) and ICUs the lowest (55.77%). Unrecognition of AKI improved from 90.3% in 2010-2011 to 70.2% in 2022-2023. AKI stage progression was linked to poorer survival. Patients with recognized AKI recovered faster than those with unrecognized AKI (8.0 vs. 9.0 days, p < 0.001). The mean follow-up time was 15.8 days, with similar rates at 28 and 90 days post-AKI for both groups. Risk factors for unrecognized AKI included lower AKI stage, baseline creatinine, absence of shock/heart disease/hypertension, and non-nephrology/surgery admissions. Non-nephrology physicians' unfamiliarity with AKI guidelines may contribute to low awareness. Improved early detection and monitoring in high-risk groups are needed.
急性肾损伤（AKI）是一种常见但常被忽视的并发症。本研究调查了2010年至2023年期间一家大型公立中国医院成人AKI的发病率、未被识别率及预后情况。计算AKI发生率，并利用随访记录评估预后。多因素逻辑回归分析确定未被识别的AKI的危险因素。在2790540例患者中，5080例符合AKI标准，总体发病率为0.18%（住院患者中为0.78%，门诊患者中为0.05%）。未被识别的AKI占76.3%。在该组中，75%为1期，16.7%为2期，8.3%为3期。骨科的未被识别率最高（94.5%），重症监护病房最低（55.77%）。AKI的未被识别率从2010 - 2011年的90.3%降至2022 - 2023年的70.2%。AKI分期进展与较差的生存率相关。已识别AKI的患者比未被识别AKI的患者恢复更快（8.0天对9.0天，p<0.001）。平均随访时间为15.8天，两组在AKI后28天和90天的发生率相似。未被识别的AKI的危险因素包括较低的AKI分期、基线肌酐水平、无休克/心脏病/高血压以及非肾病/外科入院。非肾病科医生对AKI指南不熟悉可能导致认识不足。需要改善高危人群的早期检测和监测。
