血管腔内介入治疗下肢严重缺血后急性肾损伤危险因素

Risk factors of acute renal impairment in patients with critical lower limb ischemia after undergoing endovascular interventional therapy

目的探讨血管腔内介入治疗下肢严重肢体缺血(CLI)后急性肾损伤(AKI)危险因素。方法回顾性分析168例接受血管腔内介入治疗的下肢CLI患者,对比剂均为低渗型碘克沙醇,统计发生术后AKI例数,以单因素及多因素Logistic分析筛选AKI危险因素。结果168例CLI患者中,42例(42/168,25.00%)术后发生AKI,其中1级AKI 31例,2级6例,3级5例;AKI与无AKI患者间年龄、合并糖尿病及慢性肾衰竭、术前糖化血红蛋白、血肌酐及肾小球滤过率(eGFR)差异均有统计学意义(P均<0.05)。多元Logistic回归分析结果显示,年龄及合并慢性心力衰竭、慢性肾衰竭、糖尿病均与AKI独立相关(P均<0.05)。结论血管腔内介入治疗CLI后发生AKI与患者年龄及术前并发慢性心力衰竭、慢性肾衰竭、糖尿病均有关。

Objective To explore the risk factors of acute renal impairment(AKI)in patients with critical lower limb ischemia(CLI)after endovascular interventional therapies.Methods Data of 168 CLI patients who underwent endovascular interventional treatments were retrospectively analyzed.Iodixanol was used as contrast agent for all cases.The incidence of AKI after interventions was counted,and risk factors were observed with univariate and multivariate Logistic analysis.Results Among 168 CLI patients,AKI occurred in 42 patients(42/168,25.00%)after endovascular interventional therapies,including AKI level 1 in 31 patients,level 2 in 6 and level 3 in 5 patients.Patients with AKI were older,more complicated with diabetes,chronic renal failure,chronic heart failure and worse preoperative renal function(all P<0.05).There were statistically significant differences of age,diabetes mellitus and chronic renal failure,preoperative HbA1c,creatinine and estimated glomerular filtration rate(eGFR)between AKI patients and ones without AKI(all P<0.05).According to multivariate Logistic regression analysis,age,chronic heart failure,chronic kidney disease and diabetes mellitus were independently associated with AKI(all P<0.05).Conclusion Patients'age,chronic heart failure,chronic renal failure and diabetes were associated with AKI after endovascular interventional therapies of CLI.