IMPROVED SURVIVAL FROM ACUTE RENAL-FAILURE AFTER TREATMENT WITH INTRAVENOUS ESSENTIAL L-AMINO-ACIDS AND GLUCOSE - RESULTS OF A PROSPECTIVE, DOUBLE-BLIND STUDY
IMPROVED SURVIVAL FROM ACUTE RENAL-FAILURE AFTER TREATMENT WITH INTRAVENOUS ESSENTIAL L-AMINO-ACIDS AND GLUCOSE - RESULTS OF A PROSPECTIVE, DOUBLE-BLIND STUDY
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DOI：
10.1056/nejm197304052881401
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发表时间：
1973-01-01
影响因子：
158.5
通讯作者：
FISCHER, JE
中科院分区：
文献类型：
--
作者：
ABEL, RM;BECK, CH;FISCHER, JE
在一项前瞻性、双盲临床试验中评价了静脉注射必需l-氨基酸和高渗葡萄糖（“肾衰液”）治疗急性肾衰的效果。53例成人患者在纳入研究前10天内持续了可能的肾损伤。对照组仅给予葡萄糖治疗。在研究时，两组均根据年龄、肾脏诊断和肾功能不全进行了充分随机化。28例接受肾衰竭液体治疗的患者中有21例从这些急性肾衰竭事件中恢复，而25例仅接受葡萄糖治疗的患者中有11例从这些急性肾衰竭事件中恢复（p = 0.02）。这些生存差异在高风险患者中更为明显，包括需要透析的少尿急性肾衰竭患者，以及发生肺炎、全身性脓毒症或严重胃肠道出血的患者。肾功能指标的分析表明，更快地从急性肾功能衰竭的患者治疗肾衰液体恢复。这些数据表明，使用该溶液治疗此类患者可显著提高生存率，这可能与肾功能不全的总体持续时间较短有关。
The effect of intravenous essential l-amino acids and hypertonic glucose ("renal-failure fluid") in the treatment of acute renal failure was evaluated in a prospective, double-blind clinical trial. The population of 53 adult patients had sustained a presumable renal insult within 10 days before inclusion in the study. The control group was treated with glucose alone. The two groups were adequately randomized for age, renal diagnosis and renal dysfunction at the time of the study. Twenty-one of 28 patients receiving renal-failure fluid, as compared with 11 of 25 given glucose alone, recovered from these episodes of acute renal failure (p = 0.02). These survival differences were more apparent in higher-risk patients, including those with oliguric acute renal failure, requiring dialysis, and those in whom pneumonia, generalized sepsis or major gastrointestinal hemorrhage developed. Analysis of indexes of renal function suggested more rapid recovery from acute renal failure in patients treated with renal-failure fluid. These data suggest that treatment of such patients with this solution significantly improves survival, which may be related to shorter overall duration of renal dysfunction.