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非少尿型急性肾衰竭

Nonoliguric acute renal failure.

作者信息

Anderson R J, Linas S L, Berns A S, Henrich W L, Miller T R, Gabow P A, Schrier R W

出版信息

N Engl J Med. 1977 May 19;296(20):1134-8. doi: 10.1056/NEJM197705192962002.

Abstract

To delineate the clinical spectrum of nonliguric renal failure, we studied prospectively 90 patients with acute renal failure 54 of whom were nonoliguric throughout their periods of azotemia. Although the causes of nonoliguric renal failure varied, nephrotoxic failure occurred more frequently in nonoliguric than in oliguric subjects (P is less than 0.01). As com pared to oliguric patients, those without oliguria had significantly lower urinary sodium concentrations (P is less than 0.05) and fractional excretions of sodium (P is less than 0.02), had shorter hospital stay (P is less than 0.01), had fewer septic episodes, neurologic abnormalities, gastrointestinal bleeding and acidemia, required dialysis less frequently (P is less than 0.001) and had lower mortality rate (26 per cent in nonoliguric vs. 50 per cent in oliguric patients -- P is less than 0.05). Nonoliguric renal failure occurs more often than is generally recognized and causes less morbidity and mortality than oliguric acute renal failure.

摘要

为了描述非少尿型肾衰竭的临床特征,我们对90例急性肾衰竭患者进行了前瞻性研究,其中54例在氮质血症期全程无少尿。尽管非少尿型肾衰竭的病因各异,但与少尿型患者相比,非少尿型患者中肾毒性肾衰竭更为常见(P<0.01)。与少尿型患者相比,无少尿的患者尿钠浓度显著更低(P<0.05)、钠排泄分数更低(P<0.02),住院时间更短(P<0.01),脓毒症发作、神经异常、胃肠道出血及酸血症更少,透析需求频率更低(P<0.001),死亡率更低(非少尿型患者为26%,少尿型患者为50%——P<0.05)。非少尿型肾衰竭的发生频率高于一般认知,且与少尿型急性肾衰竭相比,其发病率和死亡率更低。

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