The duration of postoperative acute kidney injury is an additional parameter predicting long-term survival in diabetic veterans.
The duration of postoperative acute kidney injury is an additional parameter predicting long-term survival in diabetic veterans.
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DOI：
10.1038/ki.2010.259
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发表时间：
2010-11
影响因子：
19.6
通讯作者：
Parikh, Chirag R.
中科院分区：
文献类型：
--
作者：
Coca, Steven G.;King, Joseph T., Jr.;Rosenthal, Ronnie A.;Perkal, Melissa F.;Parikh, Chirag R.
急性肾损伤（阿基）主要根据血清肌酐升高的幅度进行定义和分期。我们试图确定阿基的另一个维度，持续时间，是否增加了额外的预后信息。我们前瞻性研究了来自123个退伍军人事务医疗中心的35,302名糖尿病患者，他们在2000年至2004年期间接受了首次非心脏手术。主要结局是指数住院后存活者的长期死亡率。根据阿基网络（AKIN）分期（第1、2和3期）和持续时间（短[≤2天]、中[3-6天]、长[≥ 7天]），按量级对暴露（AKI）进行分层。总体而言，17.8%的患者在术后发生了至少1期阿基或以上。阿基的程度和持续时间均与长期生存率呈剂量依赖性相关（两者均为p < 0.001）。在每个AKIN分期中，阿基持续时间越长，死亡率越高（每个分层p < 0.001）。然而，在阿基持续时间的每个类别中，AKIN分期与死亡率无关。当在多变量分析中单独考虑时，较高的AKIN分期和持续时间与长期死亡风险增加独立相关。总之，阿基持续时间增加了预测阿基患者长期死亡率的额外信息。
Acute kidney injury (AKI) is primarily defined and staged according to the magnitude of rise in serum creatinine. We sought to determine if another dimension of AKI, duration, adds additional prognostic information above magnitude alone. We prospectively studied 35,302 diabetic patients from 123 Veterans Affairs Medical Centers undergoing their first non-cardiac surgery between 2000 and 2004. The main outcome was long-term mortality in those that survived the index hospitalization. The exposure, AKI, was stratified by magnitude according to the AKI Network (AKIN) stages (stages 1, 2 and 3), and by duration (short [≤2 days], medium [3-6 days], long [≥ 7 days]). Overall, 17.8% of the patients experienced at least stage 1 AKI or greater after surgery. Both the magnitude and duration of AKI were associated with long-term survival in a dose-dependent manner (p < 0.001 for both). Within each AKIN stage, longer duration of AKI was associated with a graded higher rate of mortality (p < 0.001 for each stratum). However, within each of the categories of AKI duration, the AKIN stage was not associated was mortality. When considered separately in multivariate analyses, both a higher AKIN stage and duration were independently associated with increased risk of long-term mortality. In conclusion, duration of AKI adds additional information to predict long-term mortality in patients with AKI.
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DOI：
10.1097/01.asn.0000067652.51441.21
发表时间：
2003-06-01
影响因子：
13.6
作者：
Bonventre, JV
通讯作者：
Bonventre, JV
影响因子：
2.5
作者：
Valdivieso, Jose R. Perez;Bes-Rastrollo, Maira;Lavilla, Francisco J.
通讯作者：
Lavilla, Francisco J.
DOI：
10.1186/cc6997
发表时间：
2008
期刊：
Critical care (London, England)
影响因子：
--
作者：
Lopes JA;Fernandes P;Jorge S;Gonçalves S;Alvarez A;Costa e Silva Z;França C;Prata MM
通讯作者：
Prata MM
影响因子：
19.6
作者：
Liano, F.;Felipe, C.;Severiano, S.
通讯作者：
Severiano, S.
影响因子：
13.6
作者：
Loef, BG;Epema, AH;Stegeman, CA
通讯作者：
Stegeman, CA