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[急性肾衰竭的当前研究进展]

[Current aspects of acute renal failure].

作者信息

Benoit O, Lebleu J, Noël C, Dracon M, Dequiedt P, Lelièvre G, Tacquet A

出版信息

Sem Hop. 1982 Nov 25;58(43):2499-2503.

PMID:6297041
Abstract

The retrospective review of 115 case-histories of patients with acute renal failure (ARF) seen over the last two years showed that etiologies were distributed as follows: acute tubular necrosis in 65% of cases, urinary tract obstruction in 16%, acute glomerulonephritis in 3,5%, acute interstitial nephritis (AIN) in 8% and acute microvascular nephropathy in 3,5%. The diagnostic value of renal biopsy in ARF is discussed. In spite of recent advances in the treatment of ARF, the mortality rate remains as high as 48%. This is mainly due to current etiologic circumstances, to the age of the patients and to the complications of ARF, with infectious complications being the most serious. Urea nitrogen accumulation is not a poor prognosis factor. Furosemide in high doses does not alter the prognosis but reduces the total number of dialysis indications (81% in 1970, 60% in 1980), the number of dialysis sessions per patient (1 only in 62% of patients), and the duration of the ARF episode (mean duration: 10,7 days).

摘要

对过去两年间收治的115例急性肾衰竭(ARF)患者病历的回顾性研究表明,病因分布如下:65%的病例为急性肾小管坏死,16%为尿路梗阻,3.5%为急性肾小球肾炎,8%为急性间质性肾炎(AIN),3.5%为急性微血管肾病。文中讨论了肾活检在ARF中的诊断价值。尽管近年来ARF的治疗取得了进展,但其死亡率仍高达48%。这主要归因于当前的病因情况、患者年龄以及ARF的并发症,其中感染性并发症最为严重。尿素氮蓄积并非预后不良的因素。大剂量呋塞米虽不改变预后,但可减少透析指征总数(1970年为81%,1980年为60%)、每位患者的透析次数(仅62%的患者为1次)以及ARF发作的持续时间(平均持续时间:10.7天)。

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