老年急性肾损伤的临床特点及预后危险因素分析  

Clinical Characteristics and Prognostic Risk Factors of Elderly Patients with Acute Kidney Injury

作　　者：刘小明 吴广礼[2] 黄旭东[2] 张超 LIU Xiao-ming;WU Guang-li;HUANG Xu-dong;ZHANG Chao(Chengde Medical University,Chengde,Hebei 067000,China;Department of Nephrology,Bethune International Peace Hospital of PLA,Shijiazhuang 050082,China)

机构地区：[1]承德医学院,河北承德067000 [2]解放军白求恩国际和平医院肾脏病科,石家庄050082

出　　处：《临床误诊误治》2018年第3期99-102,共4页Clinical Misdiagnosis & Mistherapy

基　　金：全军医学科研"十二五"课题(CWS12J061);全军医学科技青年培育计划(16QNP072)

摘　　要：目的探讨老年急性肾损伤(acute kidney injury,AKI)的临床特点及预后危险因素。方法选取2012年8月—2016年7月收治的AKI 206例,按年龄分为老年组(≥60岁,n=97)和非老年组(<60岁,n=109),按照患者预后将老年组分为肾功能恢复组和肾功能未恢复组。记录年龄、性别、基础疾病(高血压病、冠心病、糖尿病)、AKI分期等资料,计算肾小球滤过率(glomerular filtration rate,GFR),观察预后及危险因素。结果两组年龄、性别、基础疾病、AKIⅠ期、AKIⅢ期、GFR比较差异有统计学意义(P<0.05)。老年组出院时肾功能恢复51例(52.6%),未恢复46例(47.4%)。与肾功能未恢复组比较,肾功能恢复组AKIⅠ期、AKIⅢ期、确诊时GFR≤60 ml/(min·1.73m2)、低蛋白血症、肾脏替代疗法(renal replacement therapy,RRT)差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,低蛋白血症、AKIⅢ期、RRT是老年AKI患者预后的独立危险因素。结论老年AKI患者预后与低蛋白血症、RRT和AKIⅢ期密切相关。Objective To investigate the clinical characteristics and prognostic risk factors of elderly patients with acute kidney injury(AKI).Methods From August 2012 through July 2016,we enrolled 206 patients with AKI.The patients were divided into the elderly group(≥60 years old,n=97)and the non-elderly group(<60 years old,n=109)by age,and patients in the elderly group were further assigned to renal function recovery group and renal function non-recovery group according to the prognosis of the patients.The data of age,sex,underlying diseases(hypertension,coronary heart disease and diabetes)and AKI stage were documented.The glomerular filtration rate(GFR)was calculated,and the prognosis and risk factors were observed.Results The age,sex,underlying diseases,AKI stage I,AKI stageⅢand GFR differed significantly between the two groups(P<0.05).In the elderly group,the number of those with and without renal function recovery was 51(52.6%)and 46(47.4%)respectively at discharge from hospital.Compared with renal function non-recovery group,there were significant differences in AKI stage I,AKI stageⅢ,GFR≤60 ml/(min·1.73m 2)at diagnosis,hypoproteinemia,and renal replacement therapy(RRT)in renal function recovery group.Multivariate logistic regression analysis showed that hypoproteinemia,AKI stageⅢand RRT were independent risk factors for the prognosis of elderly patients with AKI.Conclusion Hypoproteinemia,RRT and AKI stageⅢwere closely associated with the prognosis of elderly AKI patients.

关 键 词：急性肾损伤 老年人 预后 

分 类 号：R692.51[医药卫生—泌尿科学]