240例急性肾损伤的临床分析

目的 回顾性分析急性肾损伤(AKI)的病因、病理、治疗及预后,探讨AKI的病因特点、预后影响因素.方法 收集我院的240例AKI患者的临床资料进行整理分析.结果 240例AKI患者中,肾前性AKI患者90例(占37.5%),主要病因为心功能不全、感染、体液丢失等;肾性AKI患者127例(占52.9%),主要致病因素为药...

Clinical analysis of 240 cases of acute kidney injury

Objective To investigate the cause, pathology, prognosis and risk factors of hospitalized patients with acute kidney injury （AKI） retrospectively. Methods The clinical data of hospitalized patients with AKI at First Affiliated Hospital of China Medical University from January 2005 to December 2010 were analyzed. Results The patterns of AKI included pre-renal （90, 37. 5%）, renal parenchymal （127, 52. 9%） and post-renal AKI （23, 9. 6Y0）. The etiology of 90 patients with pre-renal AKI was heart failure, infection, fluid loss. The etiology of 127 cases of renal parenchymal AKI was drug, infection. The etiology of 23 cases of post-renal AKI was stone, malignant tumors and other causes of obstruction. Seventy-two cases were subjected to renal replacement therapy. There were 40 deaths and the mortality of AKI in our study was 16. 7%. Univariate analysis revealed that age, hypertension, oliguria, hematuria, metabolic acidosis, MODS affected the prognosis of patients with AKI. The multivariable logistic regression analysis showed that age, hyperkalemia, MODS were predictors of mortality. Conclusions The causes of AKI were complex. Age, hyperkalemia and MODS were predictors of mortality. Timely renal replacement treatment can improve the prognosis of AKI.