The severity of acute kidney injury predicts progression to chronic kidney disease.
The severity of acute kidney injury predicts progression to chronic kidney disease.
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DOI：
10.1038/ki.2011.42
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发表时间：
2011-06
影响因子：
19.6
通讯作者：
中科院分区：
文献类型：
--
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急性肾损伤（AKI）与进展为晚期慢性肾脏疾病（CKD）相关。我们测试了AKI存活患者和CKD进展风险较高的患者能否在住院期间被识别出来，从而提供干预的机会。在初步诊断为AKI （ICD9代码584.xx）的退伍军人事务部医疗保健系统住院患者中进行了评估。在探索阶段，开发了三种进展为4期CKD的多变量预测模型。在验证阶段，模型在同一时间段内因心肌梗死或肺炎入院的11589例患者中进行了验证，这些患者的步枪代码为R、I或F，所有预测变量的数据都是完整的。在AKI组的5351例患者中，728例在住院后进入4期CKD。模型1、模型2、模型3均显著，“c”统计量分别为0.82、0.81、0.77。在模型验证中，当在确诊患者中进行测试时，这三个因素都非常显著，具有中等到较大的效应量和良好的预测准确性（' c' 0.81-0.82）。需要透析后康复的AKI患者发展为CKD的风险尤其高。因此，AKI的严重程度是CKD进展的可靠预测指标。
Acute kidney injury (AKI) is associated with progression to advanced chronic kidney disease (CKD). We tested whether patients who survive AKI and are at higher risk for CKD progression can be identified during their hospital admission, thus providing opportunities to intervene. This was assessed in patients in the Department of Veterans Affairs Healthcare System hospitalized with a primary diagnosis indicating AKI (ICD9 codes 584.xx). In the exploratory phase, three multivariate prediction models for progression to stage 4 CKD were developed. In the confirmatory phase, the models were validated in 11,589 patients admitted for myocardial infarction or pneumonia during the same time frame that had RIFLE codes R, I, or F and complete data for all predictor variables. Of the 5351 patients in the AKI group, 728 entered stage 4 CKD after hospitalization. Models 1, 2, and 3 were all significant with ‘c' statistics of 0.82, 0.81, and 0.77, respectively. In model validation, all three were highly significant when tested in the confirmatory patients, with moderate to large effect sizes and good predictive accuracy (‘c' 0.81–0.82). Patients with AKI who required dialysis and then recovered were at especially high risk for progression to CKD. Hence, the severity of AKI is a robust predictor of progression to CKD.
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影响因子：
5.9
作者：
Chertow, GM;Levy, EM;Daley, J
通讯作者：
Daley, J
影响因子：
13.6
作者：
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通讯作者：
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DOI：
10.1016/s0022-5223(99)70056-5
发表时间：
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作者：
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Collins, Allan J.
影响因子：
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作者：
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通讯作者：
Fadem, Stephen Z.