Long-term clinical consequences of acute kidney injury in the HIV-infected
Long-term clinical consequences of acute kidney injury in the HIV-infected
复制标题
DOI：
10.1038/ki.2010.171
复制
发表时间：
2010-09-01
影响因子：
19.6
通讯作者：
Shlipak, Michael G.
中科院分区：
文献类型：
--
作者：
Choi, Andy I.;Li, Yongmei;Shlipak, Michael G.
为了评估人类免疫缺陷病毒（HIV）感染者急性肾损伤（阿基）的长期后果，我们研究了17，325名首次住院的全国HIV登记患者。我们确定了阿基与心力衰竭、心血管事件、终末期肾病（ESRD）和出院后90天开始的死亡率风险之间的关系。根据阿基网络标准，2453例为1期; 273例为2期或3期; 334例为需要透析的阿基。在平均5.7年的随访期内，333人患有心力衰竭，673人患有心血管疾病（CVD），348人发展为ESRD，8405人死亡。在多变量校正分析中，阿基1期与死亡和ESRD相关，但与心力衰竭或其他CVD无关。除心力衰竭和心血管事件外，需要透析的阿基与长期ESRD和死亡风险增加有更强和显著的相关性。当阿基被重新分类以解释恢复时，1期恢复仍与死亡相关，但与ESRD无关。因此，在这个HIV感染者的国家样本中，我们发现阿基的临床影响似乎超出了医院环境，导致了过度的心血管风险、ESRD和死亡率。此外，阿基几乎影响了六名出院后存活至少90天的HIV患者中的一名。Kidney International（2010）78，478-485; doi：10.1038/ki.2010.171; 2010年6月2日在线发表
To evaluate the long-term consequences of acute kidney injury (AKI) in human immunodeficiency virus (HIV)-infected persons, we studied 17,325 patients in a national HIV registry during their first hospitalization. We determined the association of AKI with risk for heart failure, cardiovascular events, end-stage renal disease (ESRD), and mortality beginning 90 days after discharge. Based on AKI Network criteria, 2453 had stage 1; 273 had stage 2 or 3; and 334 had dialysis-requiring AKI. Over a mean follow-up period of 5.7 years, 333 had heart failure, 673 had cardiovascular diseases (CVDs), 348 developed ESRD, and 8405 deaths occurred. In multivariable-adjusted analyses, AKI stage 1 was associated with death and ESRD, but not heart failure or other CVD. Dialysis-requiring AKI had much stronger and significant associations with increased risk for long-term ESRD, and death in addition to heart failure and cardiovascular events. When AKI was reclassified to account for recovery, stage 1 with recovery was still associated with death, but not ESRD. Thus, in this national sample of HIV-infected persons, we found the clinical repercussions of AKI appear to extend beyond the hospital setting contributing to excess cardiovascular risks, ESRD, and mortality. Additionally, AKI affected almost one of six patients with HIV who survived at least 90 days following discharge. Kidney International (2010) 78, 478-485; doi: 10.1038/ki.2010.171; published online 2 June 2010