糖尿病肾病住院患者并发急性肾损伤的危险因素分析

Analysis on risk factors for diabetic nephropathy complicated by acute kidney injury in hospitalized patients

目的探讨糖尿病肾病(DN)住院患者并发急性肾损伤(AKI)的危险因素。方法选取628例DN住院患者为研究对象,检测尿白蛋白/肌酐比值(ACR)、血常规、血肌酐、血清白蛋白、糖化血红蛋白A1c(HbA1c)、血浆N-末端B型脑钠肽前体(NT-proBNP)、左室射血分数(LVEF)等,并计算肾小球滤过率估计值(eGFR)。分析DN住院患者并发AKI的危险因素。结果 628例DN住院患者并发AKI者35例,患病率为5.57%。严重感染为主要诱发因素,占42.86%。多因素Logistic回归分析结果显示,年龄大、高ACR、低LVEF和低eGFR是DN住院患者并发AKI的独立危险因素。结论 DN住院患者发生AKI的概率较高,年龄大、高ACR、低LVEF和低eGFR是DN住院患者并发AKI的独立危险因素。

Objective To investigate the risk factors for diabetic nephropathy(DN) complicated by acute kidney injury(AKI) in hospitalized patients.Methods A total of 628 hospitalized patients with DN were selected as subjects;their urinary albumin/creatinine ratio(ACR),complete blood count,serum creatinine,serum albumin,glycosylated hemoglobin A1c(HbA1c),plasma N-terminal pro-brain natriuretic peptide(NT-proBNP),left ventricular ejection fraction(LVEF),etc.were detected,and the estimated glomerular filtration rate(eGFR) was calculated.The risk factors for DN complicated by AKI in the hospitalized patients were analyzed.Results In the 628 hospitalized patients,DN complicated by AKI occurred in 35 patients,and the prevalence rate was 5.57%.Severe infection was the main predisposing factor,accounting for 42.86%.Multivariate Logistic regression analysis exhibited that the advanced age,high ACR,low LVEF,and low eGFR were the independent risk factors for developing AKI in the hospitalized patients with DN.Conclusion The probability of developing AKI is relatively high in the hospitalized patients with DN;advanced age,high ACR,low LVEF,and low eGFR are the independent risk factors for DN complicated by AKI in the hospitalized patients.