老年急性肾功能衰竭病因及预后因素分析

The causes and prognosis of acute renal failure in the elderly

目的探讨老年急性肾功能衰竭(ARF)的病因及预后因素。方法回顾性总结110例老年ARF的临床资料,并取同期住院的110例非老年ARF临床资料作对照,对比分析两组患者的病因、生化指标、原发慢性病及其预后。结果两组ARF病因明显不同:①老年组肾前性因素以各种感染(46.51%)、心血管疾病(34.88%)居多,非老年组则以创伤性因素(75.0%)为主;②老年组肾炎因素多见于药物中毒(61.29%)和生物中毒(25.81%),非老年组以急性肾脏疾病为主(79.59%);③老年组病死率为40.91%显著高于非老年组的15.45%(P<0.001)。影响老年组ARF预后因素主要是MODS及原发慢性病。结论根据老年ARF病因采取相应预防措施,积极防治MODS和原发慢性病,是降低老年ARF发病率和病死率的关键措施。

Objective To investigate the etiology and prognosis of acute renal failure(ARF) in the eldrly. Methods 110 elderly and 110 young patients of ARF were analyzed retrospectively.Results The causes of the two groups were different significantly.The main causes of ARF in the elderly were infection(46.51%),cardiovascular disease(34.88%).The main cause in the young was wound(75.0%);The causes of nephritis in the elderly were drug(61.29%) and biology toxicosis(25.81%),but acute kidney disease was main cause in the young;The mortality in the elderly(40.91%) was higher than that in the young(15.45%)(P<0.001).MODS and original disease were main influence factors of ARF in the elderly. Conclusion Preventive measures and treatment MODS and original diseases might improve the prognosis of ARF.