老年急性肾损伤87例临床分析

Clinical analysis of senile acute renal failure:A report of 87 cases

目的探讨老年急性肾损伤的病因、临床特点及预后。方法回顾性分析87例老年急性肾损伤住院患者的临床特点。结果 87例老年急性肾损伤患者中有60例(68.97%)合并其他慢性基础疾病,其中肾前因素50例(57.47%),肾性因素27例(31.03%),肾后梗阻10例(11.50%)。所有患者中感染(22.99%)为常见病因,其次为低血容量(20.69%)、药物(18.39%)。临床表现上62例(71.26%)出现少尿,7例无尿(8.05%)。出院后肾功能恢复正常38例(43.68%),明显改善22例(25.29%),转为慢性18例(20.69%),死亡及放弃治疗9例(10.34%)。结论发生急性肾损伤的老年患者大多存在慢性基础病,且大多为肾前性因素所导致,临床表现上少尿突出,仅部分患者肾功能完全恢复,但病死率相对较低。

Objective To analyze the clinical characteristics and prognosis of acute kidney injury （AKI） in senile patients. Meth- ods The clinical data of the patients older than 60 years old admitted to our hospital from January 2008 to December 2011 were analyzed ret- rospectively. Results A total of 87 subjects were included in this study. There were 60 patients with other predisposing chronic diseases. In- fection was the major cause of AKI in senile patients, with the following causes including hypovolemia and nephrotoxic drugs. 62 patients presented with oliguria. Complete renal function recovery was observed in 38 cases, and obviously improved in 22 cases. Conclusion Infec- tion is the major cause of AKI in senile patients, and oliguria is the commonest clinical manifestation. Only part of the patients obtain com- plete renal function recovery.