135例老年急性肾功能衰竭患者的前瞻性研究

Prospective study of acute renal failure in 135 elderly patients

目的探讨住院患者中老年急性肾功能衰竭（ARF）患者的病因、预后及影响预后的因素。方法前瞻性研究我院2003年12月至2006年12月老年ARF患者的临床资料，并与同期非老年患者进行比较。结果观察期间老年ARF患者共135例，占总ARF例数（320例）的42．2％。老年组主要病因为感染、肾后梗阻性疾病。青年组死亡51例（29．7％），60～79岁组死亡31例（32．6％），≥80岁组死亡20例（50．0％），3组病死率比较差异有统计学意义（P〈0．05）。Logistic回归分析显示少尿、原有肾功能不全以及心力衰竭是与预后相关的危险因素。结论住院患者中老年ARF的发生率及病死率高，且随着年龄增长，病死率有升高趋势，及时透析可改善其预后。

Objective To investigate the etiology,prognosis and risk factors of hospitalized elderly patients with acute renal failure （ARF）. Methods The clinical data of elderly patients with ARF in our hospital from December 2003 to December 2006 were studied prospectively. The clinical features were compared with those of the non-aged patients with ARF during the same period. Results Of 320 patients, 135 （42.2%） were identified with the onset of ARF. Infections and postrenal obstructive diseases were the major causes of ARF in the elderly. Fifty-one dead patients in the young,thirty-one in the 60-79 years old group,and twenty in the above 80 years old group（ P 〈 0.05 ）. The results of logistic regression analysis suggested that oliguria, previous renal inadequacy and heart failure were the related risk factors of prognosis. Conclusion The incidence and mortality of hospitalized elderly patients with ARF are high. With the rising of age,the mortality of ARF increases. Dialysis in time might improve the prognosis of ARF.