慢性肾衰竭急性加重的临床特征及相关因素分析

目的：探讨慢性肾衰竭（CRF）急性加重因素及其治疗措施对预后的影响。方法：对2001年1月～2005年6月住院治疗的CRF急性加重患者42例，按其加重原因、基础疾病、治疗方式和疗效进行回顾性总结。结果：CRF急性加重因素依次为各种感染（45．2％）、原发病加重（19．0％）、高血压未控制（14．3％）、水电解质紊乱（11．9％）、肾毒性药物（11．9％）、心功能不全（9．5％）、尿路梗阻（4．8％）、血高粘滞状态（2．4%），7例同时存在≥2种上述病因（16．7％）。CRF急性加重原发病以慢性肾小球肾炎（52．4％）和糖尿病肾病（11．9％）为主。积极治疗后肾功能恢复达到或接近原来水平者40例，死亡2例，死亡2例的年龄均在60岁以上。结论：对于CRF肾功能急剧恶化的患者，应积极寻找其加重因素，并采取非透析和透析相结合治疗，改善肾功能，降低病死率，延长患者生命。

Clinical Characteristics and Related Factors for Acute Aggravated Chronic Renal Failure

Objective:To investigate the acute aggravated factors of chronic renal failure (CRF) and the therapeutic effect on prognosis. Methodss42 CRF inpatients between January 2001 and June 2005 were included. The aggravated factors, basic diseases, therapeutic pattern and outcome were analyzed retrospectively. Results; The aggravated factors for CRF were infections (45.2%), aggravation of primary diseases(19. 0%), uncontrolled hypertension (14. 3%), water-electrolyte disturbancedl. 9%) and nephrotoxicity drug (11.9%). The primary diseases were mainly chronic glomerulonephritis (52.4%), diabetic ne-phropathy (11.9%). After positive treatment, the renal function recovered or returned to near the original level in 40 cases. 2 cases died, both aged above 60 years old. Conclusion:For the CRF patients with acute deterioration of renal function, the aggravated factors should be actively found out and treated with or without dialysis together to ameliorate the renal function, decrease the fatality rate and prolong the life span of the patients.