药物致急性肾衰竭36例临床分析

The clinical analysis of 36 cases of drug-induced acute renal failure

目的探讨药物性急性肾衰竭(ARF)的致病因素、临床表现、治疗等临床特点,提高药物性肾损害的诊治水平,加强临床用药的安全性。方法回顾性总结10年来我院收治的36例各种药物导致的ARF患者,从用药种类、年龄、临床表现、治疗及预后等进行分析。结果36例药物性ARF中,>60岁的患者13例占36.11%。男性23例,女性13例。首位为抗菌素15例占41.67%,其次为中草药7例占19.44%。少尿型ARF25例,非少尿型11例。36例患者中没有1例死亡。结论药物性ARF临床上既可表现为少尿型也可表现为非少尿型ARF。临床用药应避免几种肾毒药同时使用,使用过程中应密切监测肾脏功能。在出现药物性ARF时,应尽早停药,并加强支持治疗。

Objectives: To comprehend the etidogy、clinical features、treatment etc. of drug renal injury ,to improve its diagnosis and treatment level and enhance security of clinical medication. Methods: 36 cases of acute renal failure caused by drugs in our hospital from 1997 to 2007 were retrospectively reviewed and their medications、ages、etiologies、clinical features、treatment effects and prognosis were analyzed. Results: In 36 cases with acute renal failure caused by drugs,only 13 cases were elder than 60 years old(36.11%). There were 23 males and 13 females .The main drug was antibiotic( 15 ,41.67%),the second was Chinese traditional herb ( 7,19.44%) . oliguria type ARF was 25 cases and not-oliguria type 11 cases. There was no death in 36 cases. Conclusion: Drug-induced acute renal failure features oliguria type or not-oliguria type in clinic. Nephrotoxicity medicaments should be avoided using together and renal function should be monitored in the process of the use of nephrotoxicity medicaments. If drug -induced ARF nephrotoxicity medicaments should be stoped appears as soon as possible and supportive treatments strengthened.