Acute kidney disease in hospitalized acute kidney injury patients.
Acute kidney disease in hospitalized acute kidney injury patients.
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住院急性肾损伤患者的急性肾病
作者：
Yan P;Duan XJ;Liu Y;Wu X;Zhang NY;Yuan F;Tang H;Liu Q;Deng YH;Wang HS;Wang M;Duan SB
急性肾损伤（AKI）和慢性肾脏病（CKD）已成为全球性的公共卫生问题，但对急性肾脏病（AKD）的流行病学信息知之甚少-AKI和CKD之间的状态。我们的目的是探讨AKI后AKD住院患者的发病率和结局，并研究AKD在预测30天和1年不良结局方面的预后价值。2015年中国三家三级医院共识别出2,556例住院AKI患者，并随访1年，AKD及AKD分期定义参照急性疾病质量倡议16年共识报告。调整混杂变量的多变量回归分析用于检查AKD与不良结局的相关性。所有AKI患者中，AKD发生率为45.4%（1161/2556），AKI 1期患者为14.5%（141/971），AKI 2期患者为44.6%（308/691），AKI 3期患者为79.6%（712/894）。AKD 1期患者在30天内发生主要肾脏不良事件的风险（MAKE 30）（比值比[OR]，2.36; 95%置信区间95% CI [1.66 - 3.36]）高于AKD 0期患者，但当患者按AKI分期分层时，仅在AKI 3期患者中保持相关性。然而，与AKD 0期相比，AKD 2 - 3期与MAKE 30和1年慢性透析以及死亡率的风险均较高相关，与AKI分期的影响无关，OR分别为31.35（95%CI [23.42 - 41.98]）和2.68（95%CI [2.07 - 3.48]）。在危重和非危重AKI患者中，AKD分期与30天和1年内不良结局之间的相关性没有显著变化。结果表明，AKD在住院AKI患者中很常见。AKD 2 - 3期为预测AKI分期的30天和1年不良结局提供了额外信息。可能需要加强对这些患者肾功能的随访。
Acute kidney injury (AKI) and chronic kidney disease (CKD) have become worldwide public health problems, but little information is known about the epidemiology of acute kidney disease (AKD)—a state in between AKI and CKD. We aimed to explore the incidence and outcomes of hospitalized patients with AKD after AKI, and investigate the prognostic value of AKD in predicting 30-day and one-year adverse outcomes. A total of 2,556 hospitalized AKI patients were identified from three tertiary hospitals in China in 2015 and followed up for one year.AKD and AKD stage were defined according to the consensus report of the Acute Disease Quality Initiative 16 workgroup. Multivariable regression analyses adjusted for confounding variables were used to examine the association of AKD with adverse outcomes. AKD occurred in 45.4% (1161/2556) of all AKI patients, 14.5% (141/971) of AKI stage 1 patients, 44.6% (308/691) of AKI stage 2 patients and 79.6% (712/894) of AKI stage 3 patients. AKD stage 1 conferred a greater risk of Major Adverse Kidney Events within 30 days (MAKE30) (odds ratio [OR], 2.36; 95% confidence interval 95% CI [1.66–3.36]) than AKD stage 0 but the association only maintained in AKI stage 3 when patients were stratified by AKI stage. However, compared with AKD stage 0, AKD stage 2–3 was associated with higher risks of both MAKE30 and one-year chronic dialysis and mortality independent of the effects of AKI stage with OR being 31.35 (95% CI [23.42–41.98]) and 2.68 (95% CI [2.07–3.48]) respectively. The association between AKD stage and adverse outcomes in 30 days and one year was not significantly changed in critically ill and non-critically ill AKI patients. The results indicated that AKD is common among hospitalized AKI patients. AKD stage 2–3 provides additional information in predicting 30-day and one-year adverse outcomes over AKI stage. Enhanced follow-up of renal function of these patients may be warranted.
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DOI：
10.1016/j.jtcvs.2018.01.093
发表时间：
2018-06-01
影响因子：
6
作者：
Mizuguchi, K. Annette;Huang, Chuan-Chin;Frendl, Gyorgy
通讯作者：
Frendl, Gyorgy
CKD 中的 AKI：损伤加剧、修复受到抑制及其潜在机制
影响因子：
19.6
作者：
He L;Wei Q;Liu J;Yi M;Liu Y;Liu H;Sun L;Peng Y;Liu F;Venkatachalam MA;Dong Z
通讯作者：
Dong Z
急性肾脏损伤的临床试验终点。
DOI：
10.1159/000363725
发表时间：
2014
期刊：
Nephron. Clinical practice
影响因子：
--
作者：
Billings FT 4th;Shaw AD
通讯作者：
Shaw AD
DOI：
10.1186/cc13180
发表时间：
2014-01-06
期刊：
Critical care (London, England)
影响因子：
--
作者：
Goldstein SL;Chawla L;Ronco C;Kellum JA
通讯作者：
Kellum JA
影响因子：
19.6
作者：
Bucaloiu, Ion D.;Kirchner, H. Lester;Perkins, Robert M.
通讯作者：
Perkins, Robert M.