老年急性肾衰竭的临床流行病学研究

Clinical epidemiology and prognosis of elderly people acute renal failure

目的探讨老年急性肾衰竭的临床流行病学特点。方法收集1999年7月至2009年7月的老年急性肾衰竭病例234例。分析其发病情况,发病机制,病因学,获得性,病情及预后情况。结果老年急性肾衰竭占同期急性肾衰竭患者总数57.8%,并以肾前性急性肾衰(55.6%)为主。多种病因共同导致老年急性肾衰,其中以感染(25.64%)为首位病因,其次是手术(20.51%)、肾毒性药物(17.52%)、肾脏疾病(14.96%)、心衰竭(12.82%)、肿瘤(6.41%)。医源性因素是老年急性肾衰竭患者的主要获得途径,老年ARF患者多伴有多脏器衰竭及高分解代谢。老年ARF的病死率高达33.33%。结论感染、手术、肾毒性药物等医源性因素是老年急性肾衰竭的常见病因;老年ARF病情复杂,多伴有多脏器衰竭和高分解代谢,总体预后差。

Objective To investigate the epidemiology and prognosis of elderly people with acute renal failure.Methods 234 patients with ARF in our hospital from July 1999 to July 2009 were collected,patient＇s incidence,pathogenesis,etiology,acquired character,patient＇s condition and Prognosis were analyzed.Results The main causes of ARF in the elderly were as follow：infection（25.64%）,surgery（20.51%）、renal toxicity drugs（17.52%）,kidney disease（14.96%）,heart failure（12.82%）,tumor（6.41%）.Among the 234 patients,the major ARF in elderly patients was hospital-acquired ARF.Most old patients with ARF accompanied with multiple organ failure and high disassimilate.The mortality of ARF in elderly patients reached up to 33.33%.Conclusion The main causes of ARF in the elderly are infection,urgery and renal toxicity drug,The patient＇s conditions of ARF in the elderly are complicated with more multiple organ failure and high disassimilate accompanied.Total prognosis of ARF in the elderly was severely needed.