首页 | 本学科首页   官方微博 | 高级检索  
     

肝移植术后急性肾损伤的发生情况及其与预后的关系
引用本文:朱铭力,郦忆,钱家麒,夏强,王思岳,仇一骏,车妙琳,戴慧莉,倪兆慧,严玉澄. 肝移植术后急性肾损伤的发生情况及其与预后的关系[J]. 中华肾脏病杂志, 2009, 25(2): 86-92. DOI: 10.3760/cma.j.issn.1001-7097.2009.02.003
作者姓名:朱铭力  郦忆  钱家麒  夏强  王思岳  仇一骏  车妙琳  戴慧莉  倪兆慧  严玉澄
作者单位:DOI:10.3760/cma.j.issn.1001-7097.2009.02.003 基金项目:上海市医学发展基金重点研究课题(2003ZD001);上海市医药卫生基金(2007-135) 作者单位:200127 上海交通大学医学院附属仁济医院肾脏科(朱铭力、郦忆、钱家麒、仇一骏、车妙琳、戴慧莉、倪兆慧、严玉澄),移植科(夏强、王思岳)
基金项目:上海市医学发展基金重点研究课题,上海市医药卫生基金 
摘    要:
Objective To investigate the incidence of acute kidney injury ( AKI) post-orthotopic liver transplant ( OLT ) and its association with prognosis. Methods Data of 28 patients received single OLT in our hospital from 2004 to 2006 were retrospectively analyzed. The incidence of AKI was investigated by new acute kidney injury network (AKIN) criteria. The follow-up was over one year. The prognosis of AKI patients at day 28 and 1 year was evaluated by Kaplan-Meier survival analysis. The association between AKI and prognosis was examined. Results A total of 193 patients were enrolled. The average age was (48.07±10.02) years old. The ratio of male to female was 4:1. One hundred and sixteen (60.1%) patients of post-OLT AKI were found, whose AKI stage 1, 2 and 3 were 50.0%, 21.6% and 28.4% respectively. Ten (8.6%) patients required renal replacement therapy (RRT) after OLT. In AKI post-OLT patients, day 28 and 1 year mortality were significantly higher than those in non-AKI patients (15.5% vs 0, 25.9% vs 3.9%, respectively, both P<0.05). Kaplan-Meier survival analysis showed the 1-year survival rates of AKI stage 1, 2, 3 post-OLT and non-AKI were 84.0%, 81.0%, 42.4% and 90.9%, respectively. The 1-year survival rate of non-AKI was significantly higher than that of AKI stage 1, 2, 3. The 1-year survival rate of AKI stage 3 was significantly lower than that of stage 1 and 2. There was no significant difference between AKI stage 1 and 2. Scr at 1 year post-OLT was significantly higher than that of baseline [(88.35±37.15) vs (73.70±33.88) ?滋mol/L, P<0.05). The change of Scr value at 1 year compared to baseline in AKI patients was similar to non-AKI patients. However such change in AKI stage 2 and 3 was higher than that in stage 1. Conclusions The incidence of AKI post-OLT is quite high and associated to the poor prognosis in short and long periods. Renal function may decrease gradually which is associated to the AKI stage post-OLTI.

关 键 词:肾功能不全急性肝移植发生率病死率

Incidence of acute kidney injury and its association with prognosis after liver transplantation
ZHU Ming-li,LI Yi,QIAN Jia-qi,XIA Qiong,WANG Si-yue,QIU Yi-jun,CHE Miao-lin,DAI Hui-li,NI Zhao-hui,YAN Yu-cheng. Incidence of acute kidney injury and its association with prognosis after liver transplantation[J]. Chinese Journal of Nephrology, 2009, 25(2): 86-92. DOI: 10.3760/cma.j.issn.1001-7097.2009.02.003
Authors:ZHU Ming-li  LI Yi  QIAN Jia-qi  XIA Qiong  WANG Si-yue  QIU Yi-jun  CHE Miao-lin  DAI Hui-li  NI Zhao-hui  YAN Yu-cheng
Affiliation:Renal Division Renji Hospital,Shanghai Jiaotong University, School of Medicine, Shanghai 200127, China
Abstract:
Objective To investigate the incidence of acute kidney injury (AKI) post-orthotopic liver transplant (OLT) and its association with prognosis. Methods Data of 28 patients received single OLT in our hospital from 2004 to 2006 were retrospectively analyzed. The incidence of AKI was investigated by new acute kidney injury network (AKIN) criteria. The follow-up was over one year. The prognosis of AKI patients at day 28 and 1 year was evaluated by Kaplan-Meier survival analysis. The association between AKI and prognosis was examined. Results A total of 193 patients were enrolled. The average age was (48.07±10.02) years old. The ratio of male to female was 4:1. One hundred and sixteen (60.1%) patients of post-OLT AKI were found, whose AKI stage 1, 2 and 3 were 50.0%, 21.6% and 28.4% respectively. Ten (8.6%) patients required renal replacement therapy (RRT) after OLT. In AKI post-OLT patients, day 28 and 1 year mortality were significantly higher than those in non-AKI patients (15.5% vs 0, 25.9% vs 3.9%, respectively, both P<0.05). Kaplan-Meier survival analysis showed the 1-year survival rates of AKI stage 1, 2, 3 post-OLT and non-AKl were 84.0%, 81.0%, 42.4% and 90.9%, respectively. The 1-year survival rate of non-AKI was significantly higher than that of AKI stage 1, 2, 3. The 1-year survival rate of AKI stage 3 was significantly lower than that of stage 1 and 2. There was no significant difference between AKI stage 1 and 2. Sct at 1 year post-OLT was significantly higher than that of baseline [(88.35±37.15) vs (73.70±33.88) μmol/L, P<0.05). The change of Scr value at 1 year compared to baseline in AKI patients was similar to non-AKI patients. However such change in AKI stage 2 and 3 was higher than that in stage 1. Conclusions The incidence of AKI post-OLT is quite high and associated to the poor prognosis in short and long periods. Renal function may decrease gradually which is associated to the AKI stage pest-OLTI.
Keywords:Renal insufficiency  acute  Liver transplantation  Incidence  Mortality
本文献已被 万方数据 等数据库收录!
点击此处可从《中华肾脏病杂志》浏览原始摘要信息
点击此处可从《中华肾脏病杂志》下载全文
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号