155例急性肾损伤病因及预后分析

目的探讨急性肾损伤(AKI)的病因及预后。方法 155例AKI患者,依据年龄划分,老年组60例,非老年组95例,两组均给予常规的非透析治疗和(或)在此基础上加用透析治疗。对比分析两组患者的病因及预后。结果老年组AKI病因主要以肾前性多见(P<0.01),非老年组以肾性多见(P<0.01)。老年组患者肾损害程度显著高于非老年组(P<0.01)。老年组合并原发慢性病的百分率显著高于非老年组(P<0.01),存在多器官功能障碍综合征(MODS)者显著多于非老年组(P<0.01),需要血液净化治疗者显著多于非老年组(P<0.01)。非老年组的预后显著好于老年组(P<0.01)。结论老年AKI患者多死于MODS、重症感染和心血管疾病、糖尿病等合并症,而非老年AKI患者死于感染多见。积极防治MODS和各种慢性疾病,可明显降低老年人AKI发病率和病死率。

Analysis of etiology and prognosis of the acute kidney injury of 155 cases

Objective To investigate the etiology and prognosis of acute kidney injury(AKI).Methods 155 patients with AKI were divided into the elderly group(60 cases) and the young group(95 cases) according to their ages.The two groups were both treated by conventional non-dialysis and dialysis.The etiology and prognosis of both groups were analyzed and compared to each other.Results The causes of AKI of the two groups were different significantly(P<0.01).The common causes of AKI in the elderly group were pre-renal factors,while the main causes in the young group were renal parenchyma injury.The elderly group had significantly worse injury than the young group(P<0.01).And they had higher rate of suffering primary chronic diseases and MODS than the young group(P<0.01).Therefore,in the elderly group more patients needed blood purification treatment(P<0.01).The prognosis of the young group was obviously better than that of the elderly group(P <0.01).Conclusion MODS,serious infection,cardiovascular,and diabetes complications are the main causes of death of the elderly patients with AKI,while the young patients commonly die of infection.Active prevention of MODS and other kinds of primary chronic diseases can reduce AKI incidence and mortality in the elderly patients.