论文部分内容阅读
目的:重症监护室患者的急性肾损伤(AKI)的未诊断率很高,本回顾性队列研究旨在分析未被诊断的AKI的临床转归。方法:对重症监护室患者住院期间的临床资料和出院后肾功能情况进行研究。用AKIN标准诊断AKI并分级。在检验信息系统中查询患者出院后的血肌酐值并估算肾小球滤过率,判断慢性肾脏病(CKD)分期。结果:共纳入281名患者,有92例(32.7%)符合AKIN标准的AKI,其中63例(68.5%)未被临床诊断为AKI。AKI是否被诊断与AKI在3月内恢复没有相关性(P=0.703),但和第3年、第4年CKD分期进展相关。经AKI分级校正后,AKI未被诊断者第4年CKD分级进展的风险增加48.9%(OR=1.489,95%CI:1.105~1.932)。结论:重症监护室中大量的AKI未被临床诊断,这可能会促进远期CKD进展,临床上应高度重视AKI的诊断问题。
Purpose: Patients with intensive care units have a high rate of undiagnosed acute kidney injury (AKI) and this retrospective cohort study aims to analyze the clinical outcome of undiagnosed AKI. Methods: The clinical data of patients in intensive care unit during hospitalization and the renal function after discharge were studied. AKI was diagnosed using AKIN criteria and graded. In the test information system query patients after discharge of serum creatinine value and estimate glomerular filtration rate, to determine the chronic kidney disease (CKD) staging. RESULTS: A total of 281 patients were enrolled. There were 92 AKI AKI criteria (32.7%), of which 63 (68.5%) were not clinically diagnosed as AKI. Whether AKI was diagnosed had no correlation with AKI recovery within 3 months (P = 0.703) but was associated with progression of CKD stage 3 and 4. After AKI grading, there was a 48.9% (48%) increase in risk of CKD progression at year 4 in AKI without diagnosis (OR = 1.489, 95% CI: 1.105 to 1.932). Conclusion: A large number of AKI in intensive care unit have not been clinically diagnosed, which may promote the progress of long-term CKD. Clinicians should attach great importance to the diagnosis of AKI.