皮肤科住院患者急性肾损伤的流行病学研究

Epidemics study of acute kidney injury on patients in dermatology department

目的研究皮肤科住院患者急性肾损伤(AKI)的流行情况。方法以HIS数据库中7 d内至少检查过2次血肌酐的4 710例皮肤科住院患者为对象。根据KDIGO标准判断AKI。结果 AKI发生率6.3%。全身反应性银屑病、红皮病、药疹和SLE的AKI发生率为14.8%、12.8%、12.6%和12.5%,显著高于总体发生率。多变量Logistic回归分析模型中,这4类疾病是发生AKI的独立危险因素,OR值(95%可信区间)分别为2.970(2.047~4.310)、1.932(1.005~3.717)、2.446(1.752~3.415)和2.254(1.287~3.946)。AKI和非AKI患者住院病死率分别为3.1%和0.1%(P<0.001)。AKI和住院死亡相关,OR值为24.630(95%可信区间7.385~82.149)。结论 AKI在皮肤科住院患者中常见,与患者住院医疗负担相关,需重视。

Objective To assess the epidemiology and clinical correlates of acute kidney injury （AKI） on patients in department of dermatology. Methods A total of 4710 patients hospitalized in dermatology department with at least two creatinine tests within 7 days were selected as research objects.AKI was defined and staged according to Kidney Disease Improving Global Outcomes criteria. Results The incidence of AKI was 6.3%. AKI incidences of psoriasis with systemic reaction （ 14.8% ）, erythroderma （ 12.8% ）, drug eruption （ 12.6% ） and systemic lupus erythematosus （12.5%） were significant higher than the total incidence. In multivariate logistic regression model, these 4 skin diseases were independent risk factor of AKI incidence. The OR （95% confidencel interval） was 2.970 （2.047 - 4.310）, 1.932 （1.005 - 3.717）, 2.446 （1.752 - 3.415） and 2.254 （1.287 - 3.946）. The in- hospital mortality was much higher in patients with AKI than those without （3.1% vs 0.1%, P 〈 0.001 ）. And the AKI was related to inhospital death after adjusted by age and comorbidities （Odds ratio 24.630, 95% confidencel interval 7.385 - 82.149 ）. Conclusion AKI is common in patients hospitalized in department of dermatology and is associated with patiensts＇ medical burden, which shoule be noticed.