急性肾损伤在危重病患者中的预后分析

摘要

目的：依据急性肾损伤网络定义的急性肾损伤，评价其对治疗方案及预后的临床指导价值。方法回顾性分析2011年1月~2012年12月清华大学附属一院重症监护病房收住的204例内科疾病患者的临床资料，分为急性肾损伤组和非急性肾损伤组，对其预后进行统计学分析。结果179例入选患者中有60例满足 AKI的标准，入选病例的33.5％符合AKI的标准。AKI患者的肾替代治疗需求明显高于非AKI患者。AKI患者平均住院时间和ICU住院时间分别为非 AKI患者的2.2和1.7倍。未经调整的AKI患者的死亡率是45.0％，是非AKI患者的近3倍。结论2005年急性肾损伤网络制定的AKI定义在临床上可以预测重症患者的死亡率、肾替代治疗的需求以及住院时间。%Objective: The Acute Kidney Injury Network's proposed definition for acute kidney injury predicts meaningful clinical outcomes. Methods: We did a retrospective study on clinical profiles in patients with medical disease from ICU of First Af iliated Hospital of Tsinghua University between January,2011 and December, 2012.Patients were al ocated into AKI and non-AKI group for further statistical analysis of the outcomes. Results: Of the 179 selected patients, 60 patients met AKI criteria. 33.5% of the cohort met criteria for AKI. The unadjusted mortality rate of patients with AKI was 45.0%, nearly three times the mortality rate of those without AKI. The AKI patients' need of RRT was obviously higher than the non-AKI patients. Median hospital and MICU lengths of stay were 2.2 and 1.7 times higher, respectively, in patients with AKI compared with those without AKI. Conclusions: The AKIN definition of acute kidney injury predicts hospital mortality, need for renal replacement therapy, and prolonged hospital stay in critical y il patients.