联合使用甘露醇和其他利尿剂诱发急性肾损伤的危险因素

Analysis of risk factors for acute kidney injury induced by combined use of mannitol and other diuretics

目的分析患者住院期间联合使用甘露醇和其他利尿剂诱发急性肾损伤(AKI)的危险因素。方法回顾性分析2014-2017年在医院住院期间联合使用甘露醇和其他利尿剂的患者。采用Logistic回归方法分析联合使用甘露醇和其他利尿剂患者诱发AKI的危险因素。结果共纳入符合标准的联合用药患者1 668例,其中AKI发病率为23.08%。性别男(优势比[OR]=0.726, 95%置信区间[95%CI] 0.562~0.939),收缩压(OR=1.765,95%CI 1.235~2.520),β受体阻滞剂(OR=1.875,95%CI 1.418~2.478),抗心律失常药物(OR=2.220,95%CI 1.292~3.814)及胰岛素(OR=2.710,95%CI 2.109~3.482)是联合用药后AKI患病的5个独立危险因素(P<0.05)。结论男性、收缩压、β受体阻滞剂、抗心律失常药物及胰岛素是住院患者联合使用甘露醇和其他利尿剂导致AKI发生的独立危险因素。

AIM To analyze the risk factors for acute kidney injury(AKI) induced by combined use of mannitol and other diuretics during hospitalization. METHODS A retrospective analysis was performed on patients who used mannitol combined with other diuretics during the hospitalization 2014 to 2017.Logistic regression was used to analyze risk factors for AKI induced by patients taking mannitol and other diuretics. RESULTS A total of 1 668 patients who met the criteria for co-administration were included in our cohort, of which the incidence of AKI was 23.08%. The independent risk factors for AKI after combination therapy were male gender(odds ratio [OR]=0.726, 95% CI 0.562-0.939), systolic blood pressure(OR=1.765, 95% CI 1.235-2.520), β receptor inhibitor(OR=1.875, 95% CI 1.418-2.478), antiarrhythmic drugs(OR=2.220, 95% CI 1.292-3.814) and insulin(OR=2.710, 95% CI 2.109-3.482), These five factors were independent risk factors for AKI after combination therapy(P< 0.05). CONCLUSION This study finds that gender males, systolic blood pressure, β receptor inhibitors, antiarrhythmic drugs and insulin are independent risk factors for AKI in hospitalized patients using mannitol and other diuretics.