老年急性肾功能衰竭患者50例临床特点分析

The clinical characteristics of 50 cases of acute renal failure in the elderly

目的:分析老年急性肾功能衰竭(acute renal failure,ARF)患者病因特点、临床经过以及预后特点,以期探讨老年急性肾功能衰竭临床特点。方法:159例ARF患者分为老年组(50例)和非老年组(109例),两组间进行ARF病因分类、临床经过、预后转归的比较。结果:ARF肾前性、肾性、肾后性病因方面,老年组分别占60.0%、26.0%、14.0%,非老年组分别占29.4%、64.2%、6.4%。2个以上器官衰竭者,老年组占40.0%,非老年组分别占16.0%。合并慢性疾病方面,老年组高血压、糖尿病和慢性肾脏疾病分别占38.0%、24.0%、26.0%,非老年组分别占17.4%、2.8%、3.7%。病情转归方面,老年组病死率48.0%,非老年组病死率22.0%。结论:老年ARF与非老年组ARF比较,肾前性病因多见,合并症与脏器衰竭增加,病死率高。

Objective：To analyze the causes,the clinical characteristics and prognosis of acute renal failure（ARF） in elderly.Methods：A total of 159 cases of ARF were observed and 50 elderly patients compared with 109 cases of the non-elderly.Results：The patterns of ARF in elderly due to pre-renal,renal parenchymal and post renal ARF were 60.0%,26.0% and 14.0% respectively while those in non-elderly were 29.4%,64.2% and 6.4% respectively.More than 2 organ system failures in elderly and in non-elderly were 40.0% and 16.0% respectively.Pre-existing hypertension（38.0%）,diabetes mellitus（24.0%） and chronic renal diseases（26.0%） were significantly higher among the elderly patients compared to the non-elderly.The mortality rates of ARF in the elderly and the non-elderly were 48.0% and 22.0% respectively,there was significant difference in mortality between the two groups（P〈0.01）.Conclusion：Compared with the non-elderly,the main common pattern of ARF in elderly was pre-renal ARF.There are more underlying diseasea and organ system failures and higher mortality in elderly subjects with ARF.