院内慢性肾脏病基础上急性肾损伤207例临床调查  

Acute-on-chronic kidney Injury in hospitalized patients:a clinical survey

作　　者：王琴[1] 牟姗[1] 严玉澄[1] 顾乐怡[1] 朱铭力[1] 周文彦[1] 施蓓莉[1] 倪兆慧[1] 

机构地区：[1]上海交通大学医学院附属仁济医院肾脏科,上海200127

出　　处：《中国实用内科杂志》2012年第11期874-877,共4页Chinese Journal of Practical Internal Medicine

基　　金：国家自然科学基金资助(81102700);973课题资助(2012CB517602)

摘　　要：目的了解医院内慢性肾脏病基础上急性肾损伤(A-on-C)发生情况及与其预后有关的危险因素。方法回顾性分析2003年1月至2007年12月上海交通大学医学院附属仁济医院收治的A-on-C患者的临床资料,对其病因、基础肾脏疾病、预后及其影响因素等进行分析。结果 5年间共收治肾功能不全患者2045例,其中A-on-C患者207例。在207例A-on-C患者中,男121例,女86例;平均年龄(63.13±17.39)岁。住院患者中A-on-C发生率占同期住院急性肾损伤(AKI)患者的33.17%。这些患者发生A-on-C病因复杂,往往受到多重因素影响。A-on-C患者病死率达11.59%。74.88%的患者肾功能不能恢复至原来的水平,其中35.48%的患者最终只能接受永久的肾脏替代治疗。这些患者年龄偏高、伴随多种合并症且存在营养状态差、炎症状态的情况。结论住院患者中A-on-C发生率高,病因复杂,预后差,应该予以高度重视。Objective To investigate the incidence and risk factors of acute-on-chronic kidney injury （A-on-C） in hospitalized patients. Methods We did a retrospective study on the clinical profiles of patients with A-on-C hospitalized in Affiliated Renji Hospital of Shanghai Jiaotong University between 2003 and 2007 for analysis of etiology, underlying renal disease, prognosis and influencing factors. Results Of 2045 hospitalized patients with renal insufficiency during the 5 years, a cohort of 207 patients with A-on-C （ 121 males and 86 females） aged （63.13 ± 17.39） years accounting for 33.17% of acute kidney injury cases were identified. The etiology appeared complex and may be affected by multiple factors. The mortality that reached to 11.59% was also found. 74. 88% of patients could not have restored renal function and 35.48% of patients had to receive renal replacement treatment thereafter. Elderly patients were prone to develop various complications, malnutrition and inflammatory responses. Conclusion Particular attention should be attached to hospitalized patients with A-on-C featured of high morbidity, complicated etiology and poor prognosis.

关 键 词：急性肾损伤 慢性肾脏病 住院患者 

分 类 号：R572.2[医药卫生—消化系统]