223例儿童急性肾损伤的病因及预后分析

Analysis on etiology and prognosis of 223 children cases of acute kidney injury

目的探讨儿童急性肾损伤(AKI)的病因及影响预后的因素。方法回顾性分析该院AKI患儿的临床特征、病因分布及转归等情况,分析其与预后的关系。结果婴儿以肾前性因素为主,其余年龄段以肾性因素为主。单因素分析显示,AKI分期、病因、机械通气、败血症或感染性休克、合并多器官功能障碍(MODS)、酸中毒、肌酐初值、肌酐峰值、血钾是影响预后的因素,Logistic回归分析显示,机械通气、MODS、败血症或感染性休克是影响AKI预后的独立危险因素。结论儿童AKI的病因多样化,其分布具有年龄特点,机械通气、MODS、败血症或感染性休克是影响AKI预后的独立危险因素,早期诊断,积极治疗有助于改善预后。

Objective To investigate the etiology and prognostic factors of acute kidney injury（AKI） in pediatric patients. Methods The clinical data of children patients with AKI in this hospital,including the clinical features,causes and outcomes,were retrospectively analyzed. The relationship between the risk factors and prognosis was analyzed. Results Infants were dominated by the prerenal factors and the other age groups were dominated by the renal factors. The univariate analysis revealed that the AKI stage, etiology, mechanical ventilation, sepsis/septic shock, MODS, acidosis, creatinine initial value, creatinine peak value and serum potassium were the factors affecting prognosis. The Logistic regression analysis showed that mechanical ventilation, MODS and sep- sis/septic shock were the independent risk factors affecting prognosis. Conclusion The etiology of AKI in children is diverse and its distribution has the age characteristics. Mechanical ventilation, MODS and sepsis/septic shock are the independent risk factors af- fecting prognosis. The early diagnosis and the active treatment conduces to improve Dro^znosis.