住院患者急性肾损伤的病因及预后分析

Aetiology and prognosis of inpatients with acute kidney injury

目的调查本院住院患者急性肾损伤(AKI)患病情况,以了解西南地区综合性医院住院患者AKI的发病率、病因构成及预后。方法通过调查本院近2年住院患者的肾功能及尿量检测结果,筛检出AKI患者,总结分析患者的临床特征及其转归、肾功能受损的基础疾病等情况。结果观察期间住院患者AKI的发病率为3.17%,其中AKI 1～3期患者所占比列分别为47.01%、35.00%和19.99%。住院患者总病死率为2.20%,AKI患者病死率为13.82%,未发生AKI患者病死率为1.76%。引起AKI的主要病因依次为药物、严重感染、外科手术、肾后性梗阻。logistic回归分析示老年、慢性肾脏病是AKI的高危发病因素。结论住院患者AKI的发病率较高,死亡率高;及早诊断AKI对早期预防和积极干预AKI,提高AKI的生存率和改善预后具有重要意义。

Objective To determine the incidence,aetiology,and outcomes of the inpatients with acute kidney injury（AKI） and to evaluate the impacts of possible predisposing factors.Methods We retrospectively analyzed all inpatients in our hospital from recent two years and selected the AKI patients.Results The incidence of AKI was 3.2%,including stage 1（47%）,stage 2（35%） and Stage 3（18%）.The mortality of AKI（13.8%） was significantly higher than that（1.8%） of the patients without AKI（P0.05）.The average mortality in our hospital was 2.2%.The commonest causes of AKI were drugs,severe infection,surgical operation and obstruction of urinary tract.logistic analysis showed that the risk factors of AKI were old age and chronic kidney disease.Conclusion AKI has a high morbidity and mortality,which suggests that earlier diagnosis of AKI with the criteria of AKIN can promote earlier resolution and improve prognosis.