老年急性肾衰竭40例临床与病理分析

Clinical and Pathological Analysis of Senile Acute Renal Failue (Report of 40 cases)

目的:探讨老年性急性肾衰竭(ARF)患者的易发因素、临床与病理特点及预后分析。方法:本文收集40例老年人(年龄大于60岁)ARF患者临床资料进行回顾性分析。结果:①病因。急性肾小管坏死最常见,其次为急性间质性肾炎;系统性血管炎、感染因素、肿瘤因素、缺血性肾病等也不少见。②治疗。血液透析13例,连续性肾脏替代治疗(CRRT)1例,未透析26例。③预后。肾功能恢复20例,肾功能未恢复8例,死亡12例。结论:老年性急性肾衰竭好发因素多,死亡率高,伴多器官功能障碍综合征(MODS)、少尿、高分解代谢、治疗方式均影响预后。

Objective：To analyze the predisposing factors, clinical and pathological features and prognosis of senile patients with acute renal failure （ARF）. Methods：Clinical data of 40 senile ARF patients （older than 60 years） were collected and retrospectively analyzed. Results： ①The commonest causes of ARF was acute tubular necrosis （ATN）, the following causes was acute intestitial nephritis （AIN）, systemic vasculitis, infection, cancer, ischemic disease of kidney. ②13 cases received hemodialysis, 1 continous renal replacement therapy （CRRT）, 26 without dialysis. ③Renal function recovered in 20 cases, not recovered in 8 cases, died in 12 cases. Conclusion： The causes of senile ARF are various. The mortality of senile ARF is higher. The concomitant multiple organ dysfunction syndrome（MODS）, oliguria, highertabolism and management contribute to the prognosis.