慢性肾病并发急性肾衰竭75例临床分析  

Acute renal failure secondary to chronic kidney disease:a clinical analysis of 75 cases

作　　者：李军辉[1] 王锋[1] 王强庆[2] 薛勤[1] 高许萍[1] 简桂花[1] 汪年松[1] 

机构地区：[1]上海交通大学附属第六人民医院肾内科,200233 [2]华北煤炭医学院

出　　处：《上海医学》2009年第3期218-220,共3页Shanghai Medical Journal

基　　金：上海市卫生局重点攻关课题(2003ZD01);上海市自然科学基金(05ZR14086);上海市卫生局课题(034044)资助项目

摘　　要：目的探讨住院患者中慢性肾脏病基础上的急性肾衰竭(A/C)的病因、预后及影响预后的因素。方法前瞻性分析上海交通大学附属第六人民医院2003年12月—2006年12月住院患者中A/C患者的临床资料。结果观察期间住院患者中共320例发生急性肾衰竭,其中A/C患者75例,占23.4%。A/C患者中42例(56.0%)原有肾功能不全。A/C主要诱因为感染(25例)、药物(19例)和心力衰竭(10例)。A/C患者的病死率为29.3%(22/75),严重感染、少尿、原有肾功能不全或合并多器官功能障碍综合征(MODS)患者的病死率显著高于生存率(P值均<0.05)。结论住院患者中A/C的发生率高,原有肾功能不全、少尿及合并MODS者预后差,应引起足够重视。Objective To investigate the cause, prognosis and factors of prognosis in hospitalized patients with acute renal failure secondary to chronic kidney disease （A/C）. Methods The clinical data of patients with A/C, who were treated in our hospital from Dec. 2003 to Dec. 2006, were prospectively analyzed. Results Totally 320 patients developed ARF during the study period and 75 （23.4%） met the diagnostic criteria of A/C. In 75 patients with A/C, 42 （56.0%） had pre-existing chronic renal failure. The main causes of A/C included sepsis （25 cases）, drugs （ 19 cases） and congestive heart failure（ 10 cases）. The mortality rate of A/C was 29.3%. The mortality rates of patients with severe infection, re-existing chronic renal failure, oliguria or MODS, were significantly higher than their survival rates （all P〈0.05）. Conclusion The incidence of A/C is high in hospitalized patients. The prognosis of patient with pre-existing chronic renal failure, oliguria and MODS are Door, and enouah attention should be paid to this issue. （Shanahai Med J, 2009,32：218-220）

关 键 词：慢性肾脏病 急性肾衰竭 病死率 住院 

分 类 号：R692.5[医药卫生—泌尿科学] R692[医药卫生—外科学]