急性肾损伤患者经连续性肾脏替代治疗后肾功能未恢复的影响因素分析

Analysis of influencing factors of unrecovered renal function in patients with acute kidney injury after continuous renal replacement therapy

目的:分析急性肾损伤(AKI)患者经连续性肾脏替代治疗(CRRT)后肾功能未恢复的影响因素。方法:选取2019年12月至2021年2月该院收治的86例接受CRRT治疗的AKI患者进行前瞻性研究,所有患者均接受CRRT治疗,观察其治疗后肾功能恢复情况,采用多因素Logistic回归分析AKI患者经CRRT治疗后肾功能未恢复的影响因素。结果:86例AKI患者经CRRT连续治疗3个月后,肾功能未恢复者42例,占48.84%,肾功能恢复者44例,占51.16%;肾功能未恢复患者的急性生理与慢性健康评分Ⅱ(APACHEⅡ)>22分、合并糖尿病、存在慢性肾脏病、少尿或无尿、未用血管活性药物占比均高于肾功能恢复患者,差异有统计学意义(P<0.05);Logistic回归分析结果显示,APACHEⅡ评分>22分、合并糖尿病、存在慢性肾脏病、少尿或无尿、未使用血管活性药物均为AKI患者经CRRT治疗后肾功能未恢复的危险因素(OR>1,P<0.05)。结论:APACHEⅡ评分>22分、合并糖尿病、存在慢性肾脏病、少尿或无尿、未使用血管活性药物均为AKI患者经CRRT治疗后肾功能未恢复的危险因素。

Objective:To analyze the influencing factors of unrecovered renal function in patients with acute kidney injury(AKI) after continuous renal replacement therapy(CRRT).Methods:A prospective study was performed on 86 AKI patients treated with CRRT who were admitted to this hospital from December 2019 to February 2021.All patients received CRRT.The recovery of renal function was observed.Then,the multivariate Logistic regression was used to analyze the influencing factors of unrecovered renal function in the patients with AKI after CRRT.Results:After continuous CRRT for 3 months,the renal function of 42 patients among the 86 AKI patients did not recovery accounting for 48.84%,and 44 patients had recovered renal function,accounting for 51.16%.The proportions of acute physiology and chronic health evaluation score Ⅱ(APACHE Ⅱ) >22 points,complicated diabetes,chronic kidney disease,oliguria or anuria,and no use of vasoactive drugs of the patients with unrecovered renal function were higher than those of the patients with recovered renal function,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that APACHE Ⅱ score >22,complicated diabetes,chronic kidney disease,oliguria or anuria,and no use of vasoactive drugs were the risk factors for unrecovered renal function in the patients with AKI after CRRT(OR>1,P<0.05).Conclusions:APACHE Ⅱ score >22 points,complicated diabetes,chronic kidney disease,oliguria or anuria,and no use of vasoactive drugs are the risk factors for unrecovered renal function in the patients with AKI after CRRT.