老年性急性肾功能衰竭相关因素研究

Research on the correlation factors of geratologous acute renal failure

目的:探讨老年性急性肾功能衰竭(ARF)发病情况,总结老年性ARF病因和发生率,为早期防治提供理论依据。方法:收集我院2000年1月～2005年12月住院老年性ARF患者65例,分析肾前性、肾性和肾后梗阻性各种病因、发生率、治疗和转归。结果:65例患者中,肾前性28例,占43%,病因为外伤、术后失血、失液。肾性26例占40%,主要病因为药物、感染、休克等。其中药物所致12例,占46.2%。肾后梗阻性11例占17%,病因为各种泌尿道肿瘤、前列腺增生、尿路结石。18例肾活检,其中小管和间质病变14例。结论:医源性ARF是主要原因,其中药物因素已占首位。老年性ARF早期诊断有助于治疗,缩短病程,改善预后,提高存活率。

Objective：The purpose of our research was to prospectively study the incidence of geratologous acute renal failure （GARF）,and to summarize the etiology and incidence rate,so as to provide theoretical evidence for early prevention and treatment of GARF. Methods：65 patients with GARF in different causes from January ：2000 to December 2005 in our hospital were enrolled in this research.Pre-renal parenchymal and post renal causes,incidence rate ,treatment and outcome were analyzed. Results：The patients were 43 males and 22 females with mean age 67.8±2.5 years old. 28 cases with pre-renal GARF,taking up 43% ,the causes were injury, surgery and fluid loss;26 cases with renal parenchymal GARF,taking up 40% ,the causes were nephrotoxic drugs,infection and shock,in this group,nephrotoxic drugs was a major cause,taking up 46.2%.11 cases with post renal GARF,taking up 17%, the causes were urinary tumors stone and prostate hyperplasia. 14 cases with renal tubular and interstitial lesion among 18 cases with renal biopsy. Conclusion： Latrogenic ARF is main reason,in which nephrotoxic drugs have become the chief factor. The early diagnosis of GARF is in favor of treatment, shortening the course of disease, improving prognosis and decreasing the mortality.