慢性肾脏病并发急性肾损害的病因和预后

Analysis on Causes and Outcome of Patients with Acute Kidney Damage on Chronic Kidney Disease

目的：探讨慢性肾脏病并发急性肾损害的病因和预后。方法：回顾性分析我院2009年1月-2014年1月收治的慢性肾脏病并发急性肾损害患者的临床资料,按年龄将其分为Ⅰ组和Ⅱ组,分析两组患者基础病因、诱发因素和转归。结果：Ⅰ组患者急性肾损害的基础病因以糖尿病肾病（23.2%）、高血压肾损害（18.8%）、慢性肾小球肾炎（17.4%）为主,Ⅱ组患者急性肾损害的基础病因以慢性肾炎（26.3%）、高血压肾损害（18.4%）、狼疮性肾炎（13.0%）为主,诱发因素以感染、高血压、药物性肾损害为主。结论：慢性肾脏病并发急性肾损害的基础病因危险因素在两组中是不同的,Ⅰ组中的老年人更应重视感染、各种药物肾损害等,及时发现病情变化,改善患者预后。

Objective： To study the etiology and to evaluate the outcome of acute kidney damage（AKD） on chronic kidney disease（CKD）. Methods： From Jan 2009 to Jan 2014, 500 patients with AKD on CKD were divided into two groups according to their age. Later,the clinical data collected from these patients were retrospectively analyzed, covering causes, inducing and outcomes of the disease.Results： In group Ⅰ, the fundamental causes witnessed in the patients were diabetic kidney disease（23.2%）, hypertensive renal damage（18.8%） and chronic glomerulonephritis（17.4%）. In group Ⅱ, they were chronic glomerulonephritis（26.3%）, hypertensive renal damage（18.4%） and lupus nephritis（13.0%）.The major inducing factors of both groups were infection, hypertension and drug-induced renal damage. Conclusions： Acute kidney damage on chronic kidney disease shows different causes and inducing factors in the two groups.Patients in group Ⅰ, which consists of patients of older age, should pay more attention to different types of infection and renal damage caused by drugs. Keeping a close eye to the changing symptoms of patients and taking good care of them can help the prognosis and treatment of the disease.