Epidemiology of acute kidney injury: How big is the problem?
Epidemiology of acute kidney injury: How big is the problem?
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DOI：
10.1097/ccm.0b013e318168c590
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发表时间：
2008-04-01
影响因子：
8.8
通讯作者：
Schurgers, Marie
中科院分区：
文献类型：
--
作者：
Hoste, Eric A. J.;Schurgers, Marie
目的：急性肾损伤（阿基）是住院患者常见的并发症。在这篇文章中，我们提供了一个关于阿基在住院患者中流行病学的文献综述。患者和设置：综述仅限于住院患者，重点是重症监护病房患者。测量和主要结果：不太严重的阿基和接受肾脏替代治疗的阿基的人群发生率分别约为每年每百万人口2，000 - 3，000和200-300，分别这些数字与严重脓毒症和急性肺损伤的估计值相当。大约4-5%的普通重症监护病房患者将接受肾脏替代治疗，多达三分之二的重症监护病房患者将发生步枪分类定义的阿基。阿基的发病率正在上升。阿基重症监护室患者的住院时间更长，因此产生的费用更高。此外，阿基与死亡率增加相关，即使在校正协变量后也是如此。步枪等级的增加与院内死亡风险的增加相关。接受肾脏替代治疗的阿基患者的死亡率仍为50- 60%。在存活的患者中，5-20%在出院时仍依赖透析。结论：阿基的发病率很高，与急性肺损伤和严重脓毒症相当，并且与较高的住院死亡率相关。
Objective: Acute kidney injury (AKI) is a complication that occurs frequently in hospitalized patients. In this article, we provide an overview of the literature on the epidemiology of AKI in hospitalized patients.Patients and Setting: The overview is restricted to hospitalized patients, and most emphasis is put on intensive care unit patients.Measurements and Main Results: The population incidence of less severe AKI and AKI treated with renal replacement therapy is approximately 2,000-3,000 and 200-300 per million population per year, respectively. These numbers are comparable with the estimates for severe sepsis and acute lung injury. Approximately 4-5% of general intensive care unit patients will be treated with renal replacement therapy, and up to two thirds of intensive care unit patients will develop AKI defined by the RIFLE classification. The incidence of AKI is increasing. Intensive care unit patients with AKI have a longer length of stay and therefore generate greater costs. In addition, AKI is associated with increased mortality, even after correction for covariates. Increasing RIFLE class is associated with increasing risk of in-hospital death. Patients with AKI who are treated with renal replacement therapy still have a mortality rate of 50-60%. Of surviving patients, 5-20% remain dialysis dependent at hospital discharge.Conclusion: AKI has a high incidence, comparable with acute lung injury and severe sepsis, and is associated with higher hospital mortality.