中青年慢性肾功能衰竭急剧恶化危险因素分析

摘要

Objective To explore the influential factors leading to the rapid deterioration of renal function in young and middle-aged patients with chronic renal failure and thus provide basis for the prevention of the rapid deterioration of renal function. Methods Clinical data, treatments and outcomes of 44 patients with chronic renal failure who had a rapid deterioration in renal function in our hospital from 2002 to 2010 were analyzed by using regression models. Resulta Among the 44 patients, 13 had recurrence of protopathy( 29.6% ), 11 had malignant hypertension(25%),8 had severe infection(18.2%),7 had drug-associated renal dysfunction and injury (15.9%), 2 had low blood volume(4.5%), 2 had heart failure( 4.5% ), 1 had acid-base imbalance( 2.3% ). The high risk factors are recurrence and progression of protopathy, malignant hypertension, severe infection and drug-associated renal dysfunction and injury.Conclusion Many risk factors cause the rapid deterioration of renal function in young and middle-aged patients with chronic renal failure. In order to prevent or deter the rapid progression and acute deterioration of renal function in young and middle-aged patients with chronic renal failure, great importance should be attached to the high risk factors. In addition, renal failure should be early diagnosed and timely prevented,controlled and treated. The integrative therapy of the protopathy should be strengthened.%目的 探讨导致中青年慢性肾功能衰竭急剧恶化的危险因素,为防治中青年慢性肾功能衰竭患者肾功能急剧恶化提供依据.方法 回顺性分析2006-2010年收治的44例中青年慢性肾功能衰竭急剧恶化患者的临床资料、治疗及转归.结果 在导致中青年慢性肾功能衰竭患者急剧恶化的危险因素中,原发病复发加重13例(29.6%)、恶性高血压11例(25%)、严重感染8例(18.2%);药物性肾损伤7例(15.9%)、低血容量2例(4.5%)、心衰2例(4.5)、电解质酸碱平衡失调1例(2.3%).以原发病复发进展、恶性高血压、感染、药物性肾损害等为主要原因.结论 中青年慢性肾功能衰竭患者肾功能急剧恶化的危险因素较多,重视急剧恶化的高危因素并及早发现,及时预防、控制、治疗,加强原发病的一体化治疗,以阻止或延缓中青年慢性肾功能衰竭患者迅速进展和急剧恶化.