Summary： Recent report on epidemiology of acute kidney injury （AKI） is lacking for Chinese children. We aimed to investigate the risk factors for stage and prognostic factors for renal recovery in hospital- ized ch...Summary： Recent report on epidemiology of acute kidney injury （AKI） is lacking for Chinese children. We aimed to investigate the risk factors for stage and prognostic factors for renal recovery in hospital- ized children. Pediatric patients （〈18 years old） admitted during 2003 to 2013 were enrolled in this study. AKI was defined and staged using Kidney Disease Improving Global Outcomes （KDIGO） crite- ria. Logistic regression analysis was performed to determine the risk factors and prognostic factors. The morbidity of pediatric AKI was 0.31% （205/65 237）. There were 45 （22.0%） cases in stage I, 30 （14.6%） cases in stage II and 130 （63.4%） cases in stage Ill. The majority of etiologies were intrinsic renal defects （85.4%）. Age, weight, vomit, etiology, blood urea nitrogen （BUN） at admission and sev- eral blood gas measurements were associated with AKI stage III. Age （OR=0.894; 95% CI, 0.832- 0.962; P=0.003）, vomit （OR=2.375; 95% CI, 1.058-5.333; P=0.036） and BUN at admission （OR=1.135;95% CI, 1.085-1.187; P〈0.001） were identified as independent risk factors for AKI stage Ill. After treatment, 172 （83.9%） patients achieved complete or partial recovery. The mortality was 3.9%. Variables were found as prognostic factors for renal recovery, such as age, stage, hospital stay, BUN at discharge, white blood cells, red blood cells, platelets （PLTs）, blood pH and urine blood. Among them, AKI stage（stage III vs. stage I ; OR, 6.506; 95% CI, 1.640-25.816; P=0.008）, BUN at discharge （OR, 0.918; 95% CI, 0.856-0.984; P=0.016） and PLTs （OR, 1.007; 95% CI, 1.001- 1.013; P=0.027） were identified as independent prognostic factors. AKI is still common in Chinese hos- pitalized children. Identified risk factors and prognostic factors provide guiding information for clinical management of AKI.展开更多
Background Acute kidney injury （AKI） is a common complication of sepsis,which is associated with higher risks of adverse outcomes.Recently,kidney disease：improving global outcomes （KDIGO） recommended a new guidel...Background Acute kidney injury （AKI） is a common complication of sepsis,which is associated with higher risks of adverse outcomes.Recently,kidney disease：improving global outcomes （KDIGO） recommended a new guideline forAKI,including a little modification on the AKI staging criteria.Methods This retrospective study included 211 septic patients admitted to the intensive care unit （ICU） at Xiangya Hospital,Central South University from January 2008 to January 2011.AKI was diagnosed and classified according to the KDIGO or acute kidney injury network （AKIN） criteria.Differences between the AKI and non-AKI groups for baseline characteristics,laboratory examinations,etiology,outcomes,as well as the risk factors for AKI and 28-day mortality were analyzed.The reliability of the KDIGO criteria was also evaluated by comparing it with the AKIN criteria.Results The overall incidence of AKI in septic patients was 47.9％,and the 28-day mortality was 32.7％.The incidence of AKI was significantly higher in patients with more severe sepsis.Indicators of hepatic and respiratory function were significantly worse in the AKI group.Furthermore,a higher proportion of patients were infected with Enterobacter cloacae in the AKI group.The independent risk factors for AKI were shock,the number of organ failures,blood urea nitrogen （BUN）levels,and the use of vasopressors.The independent risk factors for mortality were BUN and creatine kinase-MB （CK-MB）levels.Both the KDIGO criteria and the AKIN criteria were significantly associated with 28-day mortality.Conclusions The incidence and 28-day mortality of AKI were very high in ICU septic patients.Greater attention should be paid to AKI-induced hepatic and respiratory dysfunction in clinical practice.Patients with an intra-abdominal source of infection were more likely to develop AKI.KDIGO criteria are reliable in AKI staging.展开更多
目的分析急性中毒患者行血液净化治疗后引发下肢深静脉血栓形成(lower extremity deep vein thrombosis,LEDVT)的高危因素,为预防和诊疗提供参考依据。方法收集2014年8月至2017年8月接受血液净化治疗急性药物中毒患者263例的临床资料进...目的分析急性中毒患者行血液净化治疗后引发下肢深静脉血栓形成(lower extremity deep vein thrombosis,LEDVT)的高危因素,为预防和诊疗提供参考依据。方法收集2014年8月至2017年8月接受血液净化治疗急性药物中毒患者263例的临床资料进行回顾性分析,利用Mindray床旁便携式彩色多普勒超声对血液净化治疗后患者进行检查,根据双下肢有无血栓形成,将患者分为深静脉血栓(DVT)组和非DVT组。对LEDVT影响因素进行单因素分析和Logistic多因素回归分析。结果263例血液净化患者中18例发生了下肢深静脉血栓,发生率为6.84%。多因素Logistic回归分析结果发现年龄、体重指数、心脑血管疾病、中毒程度、D-二聚体值、凝血四项、穿刺部位均是急性中毒患者行血液净化治疗后LEDVT的危险因素,OR值分别为5.406、4.891、3.976、3.010、4.002、4.412、3.453。结论年龄≥60岁、体重指数≥24 kg/m^2、有心脑血管疾病史、中度以上中毒者、D-二聚体值>0.5mg/L、凝血四项阳性、股静脉穿刺者更容易发生LEDVT。展开更多
文摘Summary： Recent report on epidemiology of acute kidney injury （AKI） is lacking for Chinese children. We aimed to investigate the risk factors for stage and prognostic factors for renal recovery in hospital- ized children. Pediatric patients （〈18 years old） admitted during 2003 to 2013 were enrolled in this study. AKI was defined and staged using Kidney Disease Improving Global Outcomes （KDIGO） crite- ria. Logistic regression analysis was performed to determine the risk factors and prognostic factors. The morbidity of pediatric AKI was 0.31% （205/65 237）. There were 45 （22.0%） cases in stage I, 30 （14.6%） cases in stage II and 130 （63.4%） cases in stage Ill. The majority of etiologies were intrinsic renal defects （85.4%）. Age, weight, vomit, etiology, blood urea nitrogen （BUN） at admission and sev- eral blood gas measurements were associated with AKI stage III. Age （OR=0.894; 95% CI, 0.832- 0.962; P=0.003）, vomit （OR=2.375; 95% CI, 1.058-5.333; P=0.036） and BUN at admission （OR=1.135;95% CI, 1.085-1.187; P〈0.001） were identified as independent risk factors for AKI stage Ill. After treatment, 172 （83.9%） patients achieved complete or partial recovery. The mortality was 3.9%. Variables were found as prognostic factors for renal recovery, such as age, stage, hospital stay, BUN at discharge, white blood cells, red blood cells, platelets （PLTs）, blood pH and urine blood. Among them, AKI stage（stage III vs. stage I ; OR, 6.506; 95% CI, 1.640-25.816; P=0.008）, BUN at discharge （OR, 0.918; 95% CI, 0.856-0.984; P=0.016） and PLTs （OR, 1.007; 95% CI, 1.001- 1.013; P=0.027） were identified as independent prognostic factors. AKI is still common in Chinese hos- pitalized children. Identified risk factors and prognostic factors provide guiding information for clinical management of AKI.
文摘Background Acute kidney injury （AKI） is a common complication of sepsis,which is associated with higher risks of adverse outcomes.Recently,kidney disease：improving global outcomes （KDIGO） recommended a new guideline forAKI,including a little modification on the AKI staging criteria.Methods This retrospective study included 211 septic patients admitted to the intensive care unit （ICU） at Xiangya Hospital,Central South University from January 2008 to January 2011.AKI was diagnosed and classified according to the KDIGO or acute kidney injury network （AKIN） criteria.Differences between the AKI and non-AKI groups for baseline characteristics,laboratory examinations,etiology,outcomes,as well as the risk factors for AKI and 28-day mortality were analyzed.The reliability of the KDIGO criteria was also evaluated by comparing it with the AKIN criteria.Results The overall incidence of AKI in septic patients was 47.9％,and the 28-day mortality was 32.7％.The incidence of AKI was significantly higher in patients with more severe sepsis.Indicators of hepatic and respiratory function were significantly worse in the AKI group.Furthermore,a higher proportion of patients were infected with Enterobacter cloacae in the AKI group.The independent risk factors for AKI were shock,the number of organ failures,blood urea nitrogen （BUN）levels,and the use of vasopressors.The independent risk factors for mortality were BUN and creatine kinase-MB （CK-MB）levels.Both the KDIGO criteria and the AKIN criteria were significantly associated with 28-day mortality.Conclusions The incidence and 28-day mortality of AKI were very high in ICU septic patients.Greater attention should be paid to AKI-induced hepatic and respiratory dysfunction in clinical practice.Patients with an intra-abdominal source of infection were more likely to develop AKI.KDIGO criteria are reliable in AKI staging.
